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General NPI Number Information
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NPI Number | 1689989964
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Entity Type | Individual
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Provider Name | JUAN MANUEL ORTEGA LEGASPI MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1 BRACE RD STE C2
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2600
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Country | US
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Telephone | 856-482-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD462128
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | MD462128
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 25MA12723500
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License Number State | NJ
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