Provider Demographics
NPI:1700828456
Name:BARTELT, ANGELA E (CRNA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:BARTELT
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:PO BOX 95000-2130
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2139
Mailing Address - Country:US
Mailing Address - Phone:201-804-2800
Mailing Address - Fax:201-804-8883
Practice Address - Street 1:120 MADISON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2055
Practice Address - Country:US
Practice Address - Phone:609-261-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00230900367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered