Provider Demographics
NPI:1083423800
Name:ORTEGA DIAZ, JHON BRAIHAN SNEHIDER (RN)
Entity type:Individual
Prefix:
First Name:JHON
Middle Name:BRAIHAN SNEHIDER
Last Name:ORTEGA DIAZ
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W 38TH ST APT 1416
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-0974
Mailing Address - Country:US
Mailing Address - Phone:929-340-8650
Mailing Address - Fax:
Practice Address - Street 1:280 HENRY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5808
Practice Address - Country:US
Practice Address - Phone:212-227-8401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY878643163W00000X
CA95371744163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse