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Individual

JENNIFER ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15 QUADE ST, GLENS FALLS, NY 12801-2724
(518) 792-3178
Mailing address
31 CARDINAL WAY, FORT ANN, NY 12827-2811

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
663788-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146001855
NY
Enumeration date
11/26/2019
Last updated
11/26/2019
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