Individual
JOSEPH VIDAL ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21527 MURDOCK AVE, QUEENS VILLAGE, NY 11429-2639
(718) 619-6620
Mailing address
21527 MURDOCK AVE, QUEENS VILLAGE, NY 11429-2639
(718) 619-6620
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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