Healthcare Provider Details

I. General information

NPI: 1588591655
Provider Name (Legal Business Name): BENA RACHEL NEWMARK ORTIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BENA RACHEL NEWMARK ORTIZ

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 CLIFFORD PL
HARRISON NY
10528-3407
US

IV. Provider business mailing address

16 CLIFFORD PL
HARRISON NY
10528-3407
US

V. Phone/Fax

Practice location:
  • Phone: 917-612-4301
  • Fax:
Mailing address:
  • Phone: 917-612-4301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number073474
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: