Provider Demographics
NPI:1336311125
Name:OSCAR T. ORTIZ, M.D.,P.C.
Entity Type:Organization
Organization Name:OSCAR T. ORTIZ, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:TANYAG
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-736-1000
Mailing Address - Street 1:1163 ROUTE 37 W
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4973
Mailing Address - Country:US
Mailing Address - Phone:732-736-1000
Mailing Address - Fax:732-736-8811
Practice Address - Street 1:1163 ROUTE 37 W
Practice Address - Street 2:SUITE A-1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4973
Practice Address - Country:US
Practice Address - Phone:732-736-1000
Practice Address - Fax:732-736-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06148100207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082005Medicare PIN