Provider Demographics
NPI:1447099155
Name:ORTIZ, SARA-ROSE MARIE
Entity type:Individual
Prefix:MRS
First Name:SARA-ROSE
Middle Name:MARIE
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 1:24 READING RD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NY
Mailing Address - Zip Code:12563-8927
Mailing Address - Country:US
Mailing Address - Phone:914-426-0951
Mailing Address - Fax:
Practice Address - Street 1:11 PEEKSKILL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-3200
Practice Address - Country:US
Practice Address - Phone:845-528-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist