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General NPI Number Information
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NPI Number | 1013568153
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Entity Type | Individual
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Provider Name | JAIME LUIS BETANCOURT DNP, MPH, APN
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Gender | Male
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 138 W 25TH ST FL 11
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City | NEW YORK
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State | NY
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Zip | 10001-7405
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Country | US
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Telephone | 646-926-5758
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Fax | 646-775-4142
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Provider Business Mailing Address
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Address Line | 500 PATERSON PLANK RD # 31043
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City | UNION CITY
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State | NJ
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Zip | 07087-3416
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Country | US
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Telephone | 732-491-1875
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01039400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 344643
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 407386
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License Number State | NY
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