Healthcare Provider Details

I. General information

NPI: 1447187372
Provider Name (Legal Business Name): NATALIE V DUFFUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 HUTCHINSON ST
CLARK NJ
07066-1725
US

IV. Provider business mailing address

52 HUTCHINSON ST
CLARK NJ
07066-1725
US

V. Phone/Fax

Practice location:
  • Phone: 347-678-6189
  • Fax:
Mailing address:
  • Phone: 347-678-6189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number646672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: