Doctor Name: | MR. DENNIS ORTIZ |
NPI Number: | 1003129768 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CASAC-T |
License Number: | 24834 |
Business Practice Address: | 1510 Waters Pl Bronx, NY - 104612700 |
Business Phone Number: | 7184099420 |
Business Fax Number: | 7188284899 |
Mailing Address: | 1510 Waters Place, BRONX |
State: | NY |
Postal Code: | 10461 |
Phone Number: | 7184099420 |
Fax Number: | 7188284899 |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 07/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 24834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |