MEDICARE: MRS. CASSANDRA ORTIZ M.S., BCBA

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	103K00000X	Behavior Analyst	1-25-86259	NJ

General Provider Information

NPI Number	:	1528922176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSANDRA ORTIZ M.S., BCBA

Provider Business Mailing Address
First Line	:	450 5TH ST APT 2E
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-2658
Country	:	US
Telephone Number	:	929-240-1325
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 5TH ST APT 2E
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-2658
Country	:	US
Telephone Number	:	929-240-1325
Fax Number	:

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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