1174667562 NPI number — MS. JULIE A BATEMAN CRNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174667562 NPI number — MS. JULIE A BATEMAN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATEMAN
Provider First Name:
JULIE
Provider Middle Name:
A
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GILIOTTI
Provider Other First Name:
JULIE
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174667562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
438 GANTTOWN RD STE B8-B9
Provider Second Line Business Mailing Address:
GANTTOWN PROFESSIONAL PLAZA
Provider Business Mailing Address City Name:
SEWELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08080-2341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-589-6034
Provider Business Mailing Address Fax Number:
856-589-6036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
438 GANTTOWN RD STE B8-B9
Provider Second Line Business Practice Location Address:
GANTTOWN PROFESSIONAL PLAZA
Provider Business Practice Location Address City Name:
SEWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08080-2341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-589-6034
Provider Business Practice Location Address Fax Number:
856-589-6036
Provider Enumeration Date:
02/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  26NJ00011500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: 26NR10072200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0189189 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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