Healthcare Provider Details

I. General information

NPI: 1376462986
Provider Name (Legal Business Name): MRS. RENEE ORTIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 CLOSTER DOCK RD APT 4
CLOSTER NJ
07624-3004
US

IV. Provider business mailing address

465 CLOSTER DOCK RD APT 4
CLOSTER NJ
07624-3004
US

V. Phone/Fax

Practice location:
  • Phone: 845-920-6051
  • Fax:
Mailing address:
  • Phone: 845-920-6051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: