Provider Demographics
NPI:1366829244
Name:PYTLOWANY, NATALIE ELIZABETH
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELIZABETH
Last Name:PYTLOWANY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MIDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3617
Mailing Address - Country:US
Mailing Address - Phone:856-649-2226
Mailing Address - Fax:
Practice Address - Street 1:2080 HWY 35
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1090
Practice Address - Country:US
Practice Address - Phone:732-671-1112
Practice Address - Fax:732-671-1127
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
NJ25MT002463002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer