Provider Demographics
NPI:1861412363
Name:ORTIZ, CARLOS R (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:ORTIZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:347 5TH AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5010
Mailing Address - Country:US
Mailing Address - Phone:212-689-7232
Mailing Address - Fax:212-725-2641
Practice Address - Street 1:347 5TH AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5010
Practice Address - Country:US
Practice Address - Phone:212-689-7232
Practice Address - Fax:212-725-2641
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2013-01-09
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Provider Licenses
StateLicense IDTaxonomies
NY1824042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56K341Medicare UPIN