Provider Demographics
NPI:1801219597
Name:MOTYLEWICZ, PATRYCJA (MS)
Entity Type:Individual
Prefix:
First Name:PATRYCJA
Middle Name:
Last Name:MOTYLEWICZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 17TH AVE APT D5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5606
Mailing Address - Country:US
Mailing Address - Phone:347-413-2734
Mailing Address - Fax:
Practice Address - Street 1:7406 17TH AVE APT D5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5606
Practice Address - Country:US
Practice Address - Phone:347-413-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency