Provider Demographics
NPI:1326602152
Name:ORTIZ, CLARISSA ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CLARISSA
Middle Name:ASHLEY
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:134 BRIDGETON PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2616
Mailing Address - Country:US
Mailing Address - Phone:856-507-2783
Mailing Address - Fax:856-221-4138
Practice Address - Street 1:1238 CHEWS LANDING RD
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-2808
Practice Address - Country:US
Practice Address - Phone:856-545-9560
Practice Address - Fax:856-497-5214
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2024-09-11
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA11966800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine