MEDICARE: VALERIE J ORTIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03473400	NJ

General Provider Information

NPI Number	:	1215374095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE J ORTIZ

Provider Business Mailing Address
First Line	:	2983 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2983 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3849
Country	:	US
Telephone Number	:	201-201-0100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2013
Last Update Date	:	11/23/2019

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Directions to “ VALERIE J ORTIZ ” Practice Location

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