Individual
FABIAN ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
119 E FORDHAM RD, BRONX, NY 10468-5404
(718) 886-9000
(718) 961-0666
Mailing address
4012 80TH ST, ELMHURST, NY 11373-1234
(718) 886-9000
(718) 961-0666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
030974
NY
363A00000X
Physician Assistant
PA9115015
FL
Other
Enumeration date
05/05/2022
Last updated
05/12/2025
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