Healthcare Provider Details

I. General information

NPI: 1083704456
Provider Name (Legal Business Name): FLORENCE DRATTLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-2998
US

IV. Provider business mailing address

395 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052
US

V. Phone/Fax

Practice location:
  • Phone: 973-731-6100
  • Fax: 973-731-0612
Mailing address:
  • Phone: 973-731-6100
  • Fax: 973-731-0612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number26NN06738300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: