Provider Demographics
NPI:1215616016
Name:RYMARZOW, KATLYN (PA-C)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:RYMARZOW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E RIDGEWOOD AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3331
Mailing Address - Country:US
Mailing Address - Phone:973-970-4000
Mailing Address - Fax:
Practice Address - Street 1:680 KINDERKAMACK RD STE 200
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1602
Practice Address - Country:US
Practice Address - Phone:201-666-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00797400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant