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General NPI Number Information
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NPI Number | 1588479398
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Entity Type | Individual
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Provider Name | CRYSTAL G ORTEGA LSW
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1400 HOOPER AVE STE 2
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2981
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Country | US
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Telephone | 732-339-3398
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Fax |
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Provider Business Mailing Address
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Address Line | 21N READING RD
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City | EDISON
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State | NJ
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Zip | 08817-2184
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Country | US
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Telephone | 201-951-4869
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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 | 44SL07239400
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License Number State | NJ
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