Berty Ati, LPN
Individual provider Active NPI Licensed Practical Nurse · Hillside, NJ
NPI 1366827156 · NPPES record last updated Jul 22, 2015
Key facts
- NPI
- 1366827156
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 309205 (NY)
- Practice address
- 571 Chapman St
Hillside, NJ 07205-1722 - Phone
- (561) 846-1369
- NPI assigned
- Jul 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 309205 | NY | Yes |
Addresses
Primary practice location
571 Chapman St
Hillside, NJ 07205-1722
Mailing address
571 Chapman St
Hillside, NJ 07205-1722
Phone (561) 846-1369
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- Fehintola O Ayangbayi
- Samantha Ada Ayudant
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All providers in Hillside, NJ · Licensed Practical Nurse in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.