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NPI Code Detail

MEDICARE: JULIO ORTIZ LMT

MEDICARE: JULIO ORTIZ LMT
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
1225700000XMassage Therapist18KT00271600NJ

General Provider Information

NPI Number : 1407513179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIO ORTIZ LMT
Provider Business Mailing Address
First Line : 115 CHRISTOPHER COLUMBUS DR STE 300
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-3551
Country : US
Telephone Number : 201-366-1118
Fax Number : 201-359-3336
Provider Business Practice Location Address
First Line : 132 NEWARK AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-2812
Country : US
Telephone Number : 201-366-1116
Fax Number : 201-366-1117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2021
Last Update Date : 11/17/2021

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