Provider Demographics
NPI:1265984934
Name:JEAN BAPTISTE, NATACHA
Entity type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:JEAN BAPTISTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 COVERT AVE UNIT 5084
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3216
Mailing Address - Country:US
Mailing Address - Phone:516-421-3589
Mailing Address - Fax:
Practice Address - Street 1:449 BEACH 67TH ST
Practice Address - Street 2:APT 2
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692
Practice Address - Country:US
Practice Address - Phone:516-421-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2025-05-08
Deactivation Date:2021-09-26
Deactivation Code:
Reactivation Date:2025-03-11
Provider Licenses
StateLicense IDTaxonomies
NY355883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily