Provider Demographics
NPI:1831295310
Name:SALIM ORTIZ, JADIYI (MD)
Entity Type:Individual
Prefix:DR
First Name:JADIYI
Middle Name:
Last Name:SALIM ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MAMARONECK AVE
Mailing Address - Street 2:SUITE # 312
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1438
Mailing Address - Country:US
Mailing Address - Phone:914-934-8481
Mailing Address - Fax:914-390-0021
Practice Address - Street 1:280 MAMARONECK AVE
Practice Address - Street 2:SUITE # 312
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1438
Practice Address - Country:US
Practice Address - Phone:914-934-8481
Practice Address - Fax:914-390-0021
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2013-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206303208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01782796Medicaid