Provider Demographics
NPI:1386650257
Name:MORATTI, MARY ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:MORATTI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 SCOTT NIXON MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:416 BELLEVUE AVE
Practice Address - Street 2:STE 104
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4513
Practice Address - Country:US
Practice Address - Phone:609-396-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0624640367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ009292AQEMedicare PIN
NJ009292Medicare PIN