Healthcare Provider Details

I. General information

NPI: 1083027072
Provider Name (Legal Business Name): LINA M ORTEGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E RIDGEWOOD AVE STE 415S
PARAMUS NJ
07652-3917
US

IV. Provider business mailing address

5410 MARYLAND WAY STE 400
BRENTWOOD TN
37027-8087
US

V. Phone/Fax

Practice location:
  • Phone: 855-212-2273
  • Fax:
Mailing address:
  • Phone: 855-212-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number269292
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL-259842
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA10279100
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number269292
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: