Provider Demographics
NPI:1730796681
Name:BORTELL, NATALIA (NP)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:BORTELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WILLOWBROOK BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7033
Mailing Address - Country:US
Mailing Address - Phone:201-691-7247
Mailing Address - Fax:
Practice Address - Street 1:155 WILLOWBROOK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7033
Practice Address - Country:US
Practice Address - Phone:201-691-7247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01056200363LF0000X
NY346654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily