Healthcare Provider Details

I. General information

NPI: 1720996556
Provider Name (Legal Business Name): NARCISO ORTIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6424 18TH AVE FL 2
BROOKLYN NY
11204-3729
US

IV. Provider business mailing address

77 FOREST HILL PKWY APT 1K
NEWARK NJ
07104-4728
US

V. Phone/Fax

Practice location:
  • Phone: 212-687-7464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR28156500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN47373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: