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NPI Code Detail

MEDICARE: JEROME JOSEPH ORTEGA DPT

MEDICARE:   JEROME JOSEPH ORTEGA  DPT
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
1225100000XPhysical Therapist40QA00827000NJ

General Provider Information

NPI Number : 1184925372
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEROME JOSEPH ORTEGA DPT
Provider Business Mailing Address
First Line : 11 EAGLE ROCK AVE
Second Line : SUITE 201
City : EAST HANOVER
State : NJ
Zip : 07936-3167
Country : US
Telephone Number : 973-887-9000
Fax Number : 973-887-3816
Provider Business Practice Location Address
First Line : 1952 ROUTE 22 E
Second Line : SUITE 101
City : BOUND BROOK
State : NJ
Zip : 08805-1545
Country : US
Telephone Number : 732-805-9005
Fax Number : 732-805-9015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2010
Last Update Date : 11/04/2010

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Directions to “ JEROME JOSEPH ORTEGA DPT” Practice Location

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