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General NPI Number Information
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NPI Number | 1821442328
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Entity Type | Individual
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Provider Name | ERIN RUSH ORTEGON
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 121 AVENUE OF THE AMERICAS FL 3
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City | NEW YORK
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State | NY
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Zip | 10013-1594
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Country | US
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Telephone | 505-272-2223
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Fax |
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Provider Business Mailing Address
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Address Line | 555 BROOME ST
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City | NEW YORK
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State | NY
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Zip | 10013-1510
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 310627-01
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License Number State | NY
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