Healthcare Provider Details

I. General information

NPI: 1336028968
Provider Name (Legal Business Name): ALEJANDRA ORTIZ RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 E MAIN ST STE 105
MOUNT KISCO NY
10549-3036
US

IV. Provider business mailing address

PO BOX 27
PETERBOROUGH NH
03458-0027
US

V. Phone/Fax

Practice location:
  • Phone: 914-510-5641
  • Fax:
Mailing address:
  • Phone: 914-510-5641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: