Provider Demographics
NPI:1801061155
Name:ORTIZ, VICTOR ANGEL II (R PH)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ANGEL
Last Name:ORTIZ
Suffix:II
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 N PLANK RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2120
Mailing Address - Country:US
Mailing Address - Phone:845-926-3600
Mailing Address - Fax:845-926-3606
Practice Address - Street 1:82 N PLANK RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2120
Practice Address - Country:US
Practice Address - Phone:845-926-3600
Practice Address - Fax:845-926-3606
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist