Search › New York › 1041S0200X
Omar Portillo
NPI 1750132213 · on the registry since 2024
Practice
- Address
- 2 6th Ave
Brentwood, NY 11717 - Phone
- (631) 434-2204
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 1041S0200X
1041S0200X
- Also registered as
- 1041C0700X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-04-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York