Provider Demographics
NPI:1265842900
Name:PAGE, STEPHANIE ORTIZ (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ORTIZ
Last Name:PAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4010
Mailing Address - Country:US
Mailing Address - Phone:203-762-3353
Mailing Address - Fax:203-761-8563
Practice Address - Street 1:249 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4010
Practice Address - Country:US
Practice Address - Phone:212-604-6575
Practice Address - Fax:646-682-9797
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268011207Q00000X, 207QB0002X
CT667799207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine