Individual
MRS. EDITH ELIZABETH ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LOUIS AVE, SOUTH FLORAL PARK, NY 11001-3525
(646) 209-9568
Mailing address
300 LOUIS AVE, SOUTH FLORAL PARK, NY 11001-3525
(646) 209-9568
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
359276
NY
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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