Healthcare Provider Details

I. General information

NPI: 1841230448
Provider Name (Legal Business Name): WENDY ORTOLANO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 COUNTY ROUTE 32
NORWICH NY
13815-1046
US

IV. Provider business mailing address

6110 COUNTY ROUTE 32 P O BOX 1046
NORWICH NY
13815-1046
US

V. Phone/Fax

Practice location:
  • Phone: 607-334-5010
  • Fax: 607-336-7326
Mailing address:
  • Phone: 607-334-5010
  • Fax: 607-336-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number019913
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: