Provider Demographics
NPI:1467722603
Name:ORTIZ-PETRESCU, LIORA (RN)
Entity Type:Individual
Prefix:
First Name:LIORA
Middle Name:
Last Name:ORTIZ-PETRESCU
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 1:515 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-3405
Mailing Address - Country:US
Mailing Address - Phone:914-576-4264
Mailing Address - Fax:914-632-3371
Practice Address - Street 1:515 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-3405
Practice Address - Country:US
Practice Address - Phone:914-576-4264
Practice Address - Fax:914-632-3371
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse