Individual
MRS. JESSICA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 MAIN ST, HACKENSACK, NJ 07601-4847
(201) 633-7375
Mailing address
132 RIVERVALE RD, RIVER VALE, NJ 07675-6248
(201) 815-6072
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ00744000
NJ
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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