MEDICARE: NATALIE T. GIANNANTONIO FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00868200	NJ

General Provider Information

NPI Number	:	1407325947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE T. GIANNANTONIO FNP-C

Provider Business Mailing Address
First Line	:	3 PLAZA DRIVE
Second Line	:	SUITE 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-3756
Country	:	US
Telephone Number	:	732-341-1380
Fax Number	:	732-505-9296

Provider Business Practice Location Address
First Line	:	3 PLAZA DRIVE
Second Line	:	SUITE 2
City	:	TOMS RIVER
State	:	NJ
Zip	:	08757-3756
Country	:	US
Telephone Number	:	732-341-1380
Fax Number	:	732-505-9296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2018
Last Update Date	:	10/02/2019

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