Healthcare Provider Details

I. General information

NPI: 1558066704
Provider Name (Legal Business Name): RAFAEL LORENZO ORTEGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

3600 FORBES AVE STE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-6700
  • Fax:
Mailing address:
  • Phone: 412-432-7400
  • Fax: 412-432-7480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD494820
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: