Basic Information
| Provider Information | |||||||||
| NPI: | 1174833487 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PITONYAK | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1515 DEKALB PIKE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194223367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102771990 | ||||||||
| FaxNumber: | 6102772007 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 DEKALB PIKE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194223367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102771990 | ||||||||
| FaxNumber: | 6102772007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2010 | ||||||||
| LastUpdateDate: | 10/20/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC006285L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.