Healthcare Provider Details

I. General information

NPI: 1720814189
Provider Name (Legal Business Name): NATALI BETANCOURTH APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 FEDERAL ST
CAMDEN NJ
08103-1539
US

IV. Provider business mailing address

291 HEATHER CROFT
EGG HARBOR TOWNSHIP NJ
08234-4636
US

V. Phone/Fax

Practice location:
  • Phone: 856-583-2400
  • Fax:
Mailing address:
  • Phone: 609-214-2029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ15134900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: