Individual
MR. ANDRI WARREN G ORTEGA X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
73 MAPLE AVE APT A2, SMITHTOWN, NY 11787-3500
(631) 576-6389
Mailing address
73 MAPLE AVE APT A2, SMITHTOWN, NY 11787-3500
(631) 576-6389
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011669
NY
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
06/28/2020
Last updated
06/28/2020
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