Doctor Name: | NIDIA ORTEGA |
NPI Number: | 1013392935 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00577000 |
Business Practice Address: | 416 Park Ave Paterson, NJ - 075041989 |
Business Phone Number: | 9736848138 |
Business Fax Number: | 9736840032 |
Mailing Address: | 416 Park Ave, PATERSON |
State: | NJ |
Postal Code: | 075041989 |
Phone Number: | 9736848138 |
Fax Number: | 9736840032 |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 07/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00577000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |