Healthcare Provider Details

I. General information

NPI: 1811277130
Provider Name (Legal Business Name): DAMARA ORTIZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE FACULTY PAVILION
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4404 PENN AVENUE FACULTY PAVILION SUITE 1200
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5070
  • Fax: 412-692-6472
Mailing address:
  • Phone: 412-692-5070
  • Fax: 412-692-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberMD454740
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number267303
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: