Provider Demographics
NPI:1215406459
Name:ELTABAA, NATALIA (NP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ELTABAA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:457 HADDONFIELD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2223
Mailing Address - Country:US
Mailing Address - Phone:844-542-2273
Mailing Address - Fax:856-256-1188
Practice Address - Street 1:457 HADDONFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2223
Practice Address - Country:US
Practice Address - Phone:844-542-2273
Practice Address - Fax:856-256-1188
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00873400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner