Healthcare Provider Details

I. General information

NPI: 1902669799
Provider Name (Legal Business Name): NATASHA MARFATIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 10/23/2026
Certification Date: 10/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROSPECT AVE STE 907
HACKENSACK NJ
07601-1989
US

IV. Provider business mailing address

20 PROSPECT AVE STE 907
HACKENSACK NJ
07601-1989
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-2550
  • Fax:
Mailing address:
  • Phone: 201-342-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00853300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: