Provider Demographics
NPI:1518337153
Name:ORTIZ, BEATRIS
Entity Type:Individual
Prefix:
First Name:BEATRIS
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CHILHOWIE DR
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3201
Mailing Address - Country:US
Mailing Address - Phone:973-769-3850
Mailing Address - Fax:
Practice Address - Street 1:855 ROUTE 10 E
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-1926
Practice Address - Country:US
Practice Address - Phone:973-927-0931
Practice Address - Fax:973-927-3757
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker