Healthcare Provider Details

I. General information

NPI: 1891939096
Provider Name (Legal Business Name): PATRICIA GATANIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 05/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 IRVING AVE
BRIDGETON NJ
08302-2123
US

IV. Provider business mailing address

2038 CARMEL RD
MILLVILLE NJ
08332-9754
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-5555
  • Fax: 856-455-5405
Mailing address:
  • Phone: 856-825-6810
  • Fax: 856-327-3320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR11938500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: