Provider Demographics
NPI:1336112390
Name:PYONTEK, MARIA G (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:G
Last Name:PYONTEK
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1725 HWY 35
Mailing Address - Street 2:SUITE B
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3488
Mailing Address - Country:US
Mailing Address - Phone:732-681-1063
Mailing Address - Fax:732-681-2922
Practice Address - Street 1:1725 HWY 35
Practice Address - Street 2:SUITE B
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719-3488
Practice Address - Country:US
Practice Address - Phone:732-681-1063
Practice Address - Fax:732-681-2922
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2012-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB63399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG53090Medicare UPIN