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Individual

GABRIELE CLARK ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA, COA

Contact information

Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
733 LAUREL AVE, ALDAN, PA 19018-4307
(484) 493-8244

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
04/10/2023
Last updated
04/10/2023
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