Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 022091-1 | NY |
NPI | 1043798630 |
---|---|
Provider Name | Jason Pytlik |
First Address | Township Of Washington, NJ 07676-5033 |
Second Address | New York, NY 10016-9196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2018 |
Last Update Date | 06/08/2018 |