MEDICARE: MISS ANISA J ORTIZ NP

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	363LA2200X	Adult Health Nurse Practitioner	SP023317	PA
2	363LG0600X	Gerontology Nurse Practitioner	26NJ01143200	NJ
3	363LG0600X	Gerontology Nurse Practitioner	SP023317	PA

General Provider Information

NPI Number	:	1427642537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANISA J ORTIZ NP

Provider Business Mailing Address
First Line	:	2901 MEREDITH PL
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-2258
Country	:	US
Telephone Number	:	267-455-9230
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1333
Country	:	US
Telephone Number	:	267-455-9230
Fax Number	:	215-358-1041

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

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	04/01/2025

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