Individual
ULIANA FATEEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
456 CHESTNUT ST STE 102, LAKEWOOD, NJ 08701-6124
(732) 282-7200
Mailing address
96 ALPINE TRL, SPARTA, NJ 07871-1529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26NJ15161500
NJ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
26NJ15161500
NJ
363L00000X
Nurse Practitioner
Primary
26NJ15161500
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ15161500
NJ
363LP2300X
Primary Care Nurse Practitioner
26NJ15161500
NJ
Other
Enumeration date
07/18/2025
Last updated
07/20/2025
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