Provider Demographics
NPI:1336938562
Name:ASCH-ORTIZ, JESSE EMMANUEL (LCAT)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:EMMANUEL
Last Name:ASCH-ORTIZ
Suffix:
Gender:
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 SHANNON PL APT 1
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2063
Mailing Address - Country:US
Mailing Address - Phone:631-219-0982
Mailing Address - Fax:
Practice Address - Street 1:456 SHANNON PL APT 1
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2063
Practice Address - Country:US
Practice Address - Phone:631-219-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002380225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist