Marco Ortiz

Individual provider Active NPI Other Technician · Peralta, NM

NPI 1497201859 · NPPES record last updated Aug 26, 2016

Key facts

NPI
1497201859
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
46 Monica Rd
Peralta, NM 87042-5171
Phone
(505) 681-1530
NPI assigned
Aug 26, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

46 Monica Rd
Peralta, NM 87042-5171

Mailing address

46 Monica Rd
Peralta, NM 87042-5171
Phone (505) 681-1530

Other providers in Peralta, NM

All providers in Peralta, NM · Other Technician in New Mexico

Sources for this page

Verify at the official NPI Registry.