Healthcare Provider Details

I. General information

NPI: 1871838110
Provider Name (Legal Business Name): NATASHA ELLEN PETERMAN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 ROUTE 22 BUILDING 13, SUITE 1302
BRANCHBURG NJ
08876-3476
US

IV. Provider business mailing address

3322 ROUTE 22 BUILDING 13, SUITE 1302
BRANCHBURG NJ
08876-3476
US

V. Phone/Fax

Practice location:
  • Phone: 908-526-0700
  • Fax: 908-526-9988
Mailing address:
  • Phone: 908-526-0700
  • Fax: 908-526-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ00411100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421108
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP013748
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: