Provider Demographics
NPI:1962556829
Name:ORTIZ, ADANURBY
Entity type:Individual
Prefix:
First Name:ADANURBY
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADANURBY
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDM, MS, CCC-SLP
Mailing Address - Street 1:916 PALISADE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-9511
Mailing Address - Country:US
Mailing Address - Phone:201-543-9436
Mailing Address - Fax:201-766-1864
Practice Address - Street 1:309B 48TH STREET
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087
Practice Address - Country:US
Practice Address - Phone:201-553-0022
Practice Address - Fax:201-553-0023
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00440000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist