Healthcare Provider Details

I. General information

NPI: 1336059542
Provider Name (Legal Business Name): BEATRICE C MORDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 ORLANDO DR
SICKLERVILLE NJ
08081-4484
US

IV. Provider business mailing address

58 ORLANDO DR
SICKLERVILLE NJ
08081-4484
US

V. Phone/Fax

Practice location:
  • Phone: 347-622-0083
  • Fax:
Mailing address:
  • Phone: 347-622-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15626700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: