Provider Demographics
NPI:1265256705
Name:PERETZ, BATSHEVA (FNP-C)
Entity type:Individual
Prefix:
First Name:BATSHEVA
Middle Name:
Last Name:PERETZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 SUSAN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1212
Mailing Address - Country:US
Mailing Address - Phone:848-240-5304
Mailing Address - Fax:
Practice Address - Street 1:603 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1216
Practice Address - Country:US
Practice Address - Phone:732-730-9111
Practice Address - Fax:732-595-1330
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15191500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily