Individual
CYRUS ORTALLA ROBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-1622
(215) 707-0943
Mailing address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-3911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP033518
PA
363LA2100X
Acute Care Nurse Practitioner
1135940
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
SP033518
PA
Other
Enumeration date
01/02/2024
Last updated
05/11/2026
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