Individual
MADELINE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
521 W 181ST ST, FREEPORT, NEW YORK, NY 10033-5102
(347) 756-6000
Mailing address
124 SMITH ST APT 1E, FREEPORT, NY 11520-4466
(516) 497-3746
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016507-1
NY
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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