Provider Demographics
NPI:1033360722
Name:ORTIZ, SONAMY B (RN)
Entity Type:Individual
Prefix:MISS
First Name:SONAMY
Middle Name:B
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ASHLAND ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2550
Mailing Address - Country:US
Mailing Address - Phone:508-425-9934
Mailing Address - Fax:508-853-8593
Practice Address - Street 1:12 ASHLAND ST APT 2L
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2550
Practice Address - Country:US
Practice Address - Phone:508-425-9934
Practice Address - Fax:508-853-8593
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232408163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1301071OtherGROUP NUMBER