Individual
ITZEL LEILANI ORTIZ PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W 38TH ST RM 817, NEW YORK, NY 10018-3541
(212) 695-4554
Mailing address
11 4TH ST, BROOKLYN, NY 11231-4510
(313) 265-7905
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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