Provider Demographics
NPI:1336819200
Name:RECCHIA, NATALIA ALEXA (ANP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:ALEXA
Last Name:RECCHIA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3625
Mailing Address - Country:US
Mailing Address - Phone:908-692-5902
Mailing Address - Fax:
Practice Address - Street 1:12 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3625
Practice Address - Country:US
Practice Address - Phone:908-692-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01199900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care