Provider Demographics
NPI:1902359847
Name:ORTEGA, LOURDES (NP)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 65TH ST APT 26M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4997
Mailing Address - Country:US
Mailing Address - Phone:917-342-5322
Mailing Address - Fax:
Practice Address - Street 1:9920 4TH AVE STE 310
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8331
Practice Address - Country:US
Practice Address - Phone:718-921-1672
Practice Address - Fax:718-630-5236
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340271-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NYG100000410Medicare Oscar/Certification
WI331009Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
WI331945Medicare Oscar/Certification
WI331043Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
WI331947Medicare Oscar/Certification