MEDICARE: MARIMAR ORTEGA FNP

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	363LF0000X	Family Nurse Practitioner	F359063	NY

General Provider Information

NPI Number	:	1295681617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIMAR ORTEGA FNP

Provider Business Mailing Address
First Line	:	844 HUNTINGTON TPKE
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-1246
Country	:	US
Telephone Number	:	917-561-1950
Fax Number	:

Provider Business Practice Location Address
First Line	:	3338 85TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1534
Country	:	US
Telephone Number	:	917-561-1950
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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