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NPI Code Detail

MEDICARE: JOSE R ORTIZ ORTIZ LCSW

MEDICARE: JOSE R ORTIZ ORTIZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker072396NY

General Provider Information

NPI Number : 1134175722
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE R ORTIZ ORTIZ LCSW
Provider Business Mailing Address
First Line : PO BOX 120184
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-0184
Country : US
Telephone Number : 718-643-0232
Fax Number : 718-596-6655
Provider Business Practice Location Address
First Line : 10 HANOVER PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5840
Country : US
Telephone Number : 718-222-1518
Fax Number : 718-222-4376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/08/2007

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Directions to “ JOSE R ORTIZ ORTIZ LCSW” Practice Location

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