Individual
MANUEL A. ORTA COBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 NYE RD STE 105, GLASTONBURY, CT 06033-1281
(860) 375-5088
(860) 590-2030
Mailing address
PO BOX 994, GLASTONBURY, CT 06033-0994
(860) 375-5088
(860) 590-2030
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101253331
VA
208000000X
Pediatrics Physician
Primary
56881
CT
208000000X
Pediatrics Physician
ME119697
FL
390200000X
Student in an Organized Health Care Education/Training Program
14868
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010977100
—
FL
Enumeration date
06/28/2012
Last updated
09/19/2023
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