Provider Demographics
NPI:1386188670
Name:ORTEGA, FRIEDRICH CO (RPT)
Entity Type:Individual
Prefix:MR
First Name:FRIEDRICH
Middle Name:CO
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 LURTING AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1305
Mailing Address - Country:US
Mailing Address - Phone:929-444-8114
Mailing Address - Fax:
Practice Address - Street 1:1913 LURTING AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1305
Practice Address - Country:US
Practice Address - Phone:929-444-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2019-12-05
Deactivation Date:2018-07-03
Deactivation Code:
Reactivation Date:2019-06-18
Provider Licenses
StateLicense IDTaxonomies
NY038845-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist