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Individual

MICHAEL A ORTIZ

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1265 PATERSON PLANK RD, SECAUCUS, NJ 07094-3242
(201) 863-0110
(201) 863-2105
Mailing address
70 VANDERBECK LN, MAHWAH, NJ 07430-3139
(201) 863-0110

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA028003600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1388509
NJ
Enumeration date
06/12/2006
Last updated
07/08/2007
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