Healthcare Provider Details

I. General information

NPI: 1407783350
Provider Name (Legal Business Name): JENNY E ORTEGA AU.D.
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E MAIN ST STE 203
BABYLON NY
11702-3532
US

IV. Provider business mailing address

3745 58TH ST
WOODSIDE NY
11377-2462
US

V. Phone/Fax

Practice location:
  • Phone: 347-395-9405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: