Healthcare Provider Details

I. General information

NPI: 1770487506
Provider Name (Legal Business Name): TATYANA OPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1 MEETING HOUSE RD
WRIGHTSTOWN NJ
08562-1836
US

IV. Provider business mailing address

1 MEETING HOUSE RD
WRIGHTSTOWN NJ
08562-1836
US

V. Phone/Fax

Practice location:
  • Phone: 732-692-3611
  • Fax:
Mailing address:
  • Phone: 732-692-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN60847
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: