Individual
WALESKA ORTIZ-AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
503 RACEBROOK RD, ORANGE, CT 06477-2515
(203) 675-5354
Mailing address
503 RACEBROOK RD, ORANGE, CT 06477-2515
(203) 675-5354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
004772
CT
Other
Enumeration date
10/31/2011
Last updated
04/11/2012
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