Ivette Becerra Ortiz
Nurse Practitioner - Pediatrics
374 Grand Avenue Fair Haven Community Health Ctr
New Haven
, Connecticut 06513
Ivette Becerra Ortiz
Nurse Practitioner - Pediatrics
374 Grand Avenue Fair Haven Community Health Ctr
New Haven
, Connecticut 06513
(860) 436-4126
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Ivette Becerra Ortiz
- 275 Wolcott Hill Road
- Weathersfield, CT
- Zip : 06109-2033
- Phone : (860) 436-4126
Second Address
- Ivette Becerra Ortiz
- 374 Grand Avenue Fair Haven Community Health Ctr
- New Haven, CT
- Zip : 06513
- Fax : (203) 777-8506
- Phone : (203) 777-7411
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 002875 | CT |
National Provider Identifier
| NPI | 1033224670 |
|---|---|
| Provider Name | Ivette Becerra Ortiz |
| First Address | Weathersfield, CT 06109-2033 |
| Second Address | New Haven, CT 06513 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0000221420102 | UNITED HEALTHCARE (01) | |
| 330281 | WELLCARE (01) | |
| P3598502 | OXFORD (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.