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General NPI Number Information
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NPI Number | 1023824067
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Entity Type | Individual
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Provider Name | KRYSTAL CYNTHIA ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 3000 VERMELLA WAY APT 319
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-4824
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Country | US
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Telephone | 973-653-8085
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Fax |
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Provider Business Mailing Address
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Address Line | 371 HOES LN STE 200
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City | PISCATAWAY
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State | NJ
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Zip | 08854-4143
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Country | US
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Telephone | 848-308-7272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06869900
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License Number State | NJ
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