Provider Demographics
NPI:1730999038
Name:ORTEGA, JAN ISAAC (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:ISAAC
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E 32ND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5595
Mailing Address - Country:US
Mailing Address - Phone:212-759-2282
Mailing Address - Fax:212-379-2123
Practice Address - Street 1:50 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2848
Practice Address - Country:US
Practice Address - Phone:914-358-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist