Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 010604 | NY |
NPI | 1023280245 |
---|---|
Provider Name | Robert Ortiz |
First Address | New York, NY 10170-0002 |
Second Address | New York, NY 10170-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2008 |
Last Update Date | 27/03/2008 |