Provider Demographics
NPI:1386065266
Name:RESHETAR, BEATA (DNP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BEATA
Middle Name:
Last Name:RESHETAR
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:BEATA
Other - Middle Name:
Other - Last Name:RESHETAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, FNP-C
Mailing Address - Street 1:500 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-2228
Mailing Address - Country:US
Mailing Address - Phone:917-443-5766
Mailing Address - Fax:
Practice Address - Street 1:500 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-2228
Practice Address - Country:US
Practice Address - Phone:917-443-5766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00869700363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00869700OtherCOMMERCIAL INSURANCES
NJ26NJ00869700OtherAPRN LICENSE