Individual
JILL BORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3760 BROOKSIDE RD, MACUNGIE, PA 18062-1741
(610) 966-4646
(610) 965-6201
Mailing address
3760 BROOKSIDE RD, MACUNGIE, PA 18062-1741
(610) 966-4646
(610) 965-6201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS005827L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001189992003
—
PA
01
—
505543
BLUE CROSS / BLUE SHIELD
PA
01
—
P00644913
RAILROAD MEDICARE
PA
Enumeration date
03/16/2006
Last updated
09/06/2012
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