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Individual

MRS. JOHANNA MARIA ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
8 MAPLE AVE, BAY SHORE, NY 11706-8722
(631) 228-8347
Mailing address
130 SHERMAN ST, BRENTWOOD, NY 11717-2718
(632) 796-3954

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F346690-01
NY

Other

Enumeration date
02/10/2021
Last updated
02/10/2021
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