Individual
DIVINE UNIVERSE ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
79A UTICA AVE, BROOKLYN, NY 11213-1336
(917) 536-5765
Mailing address
79A UTICA AVE, BROOKLYN, NY 11213-1336
(917) 536-5765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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