Provider Demographics
NPI:1912620543
Name:MOATI, ELIZABETH FABIANA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FABIANA
Last Name:MOATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZZY
Other - Middle Name:
Other - Last Name:MOATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:37 ROCHELLE PKWY
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4651
Mailing Address - Country:US
Mailing Address - Phone:201-724-0359
Mailing Address - Fax:
Practice Address - Street 1:37 ROCHELLE PKWY
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4651
Practice Address - Country:US
Practice Address - Phone:201-724-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula