Provider Demographics
NPI:1538582689
Name:PAZDERNIK, MARY KATHERINE (LCAT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATHERINE
Last Name:PAZDERNIK
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
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Mailing Address - Street 1:382 ATLANTIC AVE
Mailing Address - Street 2:#2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-1703
Mailing Address - Country:US
Mailing Address - Phone:917-370-6792
Mailing Address - Fax:
Practice Address - Street 1:1 HOYT ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5809
Practice Address - Country:US
Practice Address - Phone:718-802-0666
Practice Address - Fax:718-858-9493
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001300-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist