Provider Demographics
NPI:1013932771
Name:PAULOVITS, ILDIKO (OT)
Entity Type:Individual
Prefix:MRS
First Name:ILDIKO
Middle Name:
Last Name:PAULOVITS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PLEASANT VALLEY WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2956
Mailing Address - Country:US
Mailing Address - Phone:973-325-3422
Mailing Address - Fax:973-325-0825
Practice Address - Street 1:75 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2735
Practice Address - Country:US
Practice Address - Phone:973-664-9899
Practice Address - Fax:973-664-1875
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00125000225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091927PMTMedicare ID - Type Unspecified