Provider Demographics
NPI:1912542697
Name:LOUIS, BATULIO
Entity Type:Individual
Prefix:
First Name:BATULIO
Middle Name:
Last Name:LOUIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HIGH ST
Mailing Address - Street 2:FL 2A
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1476
Mailing Address - Country:US
Mailing Address - Phone:973-256-3100
Mailing Address - Fax:
Practice Address - Street 1:17 FURLER ST STE 3
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1830
Practice Address - Country:US
Practice Address - Phone:973-256-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-17
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01127300363LG0600X, 363L00000X
NJHP0284900376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemaker