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General NPI Number Information
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NPI Number | 1649451527
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Entity Type | Organization
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Legal Business Name | VINCENT ORTOLANO MD PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 8120 CONSTITUTION PL NE SUITE 220
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7625
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Country | US
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Telephone | 505-294-6979
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Fax | 505-294-6986
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Provider Business Mailing Address
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Address Line | 8120 CONSTITUTION PL NE SUITE 220
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7625
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Country | US
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Telephone | 505-294-6979
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Fax | 505-294-6986
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Authorized Official
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Title or Position | PHYSICIAN
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Name | VINCENT ORTOLANO
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Credential | M.D.
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Telephone | 505-294-6979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 92114
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License Number State | NM
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