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General NPI Number Information
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NPI Number | 1295561017
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Entity Type | Organization
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Legal Business Name | ORTEGA TELEMEDICINE LLC
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 559 PENN ST
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-3237
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Country | US
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Telephone | 848-348-9812
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Fax | 732-358-0805
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Provider Business Mailing Address
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Address Line | 559 PENN ST
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-3237
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Country | US
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Telephone | 848-348-9812
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Fax | 732-358-0805
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Authorized Official
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Title or Position | OWNER
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Name | MR. FELIX ORTEGA
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Credential | PA
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Telephone | 732-485-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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