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General NPI Number Information
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NPI Number | 1194234377
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Entity Type | Individual
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Provider Name | KATHRYN PATRICIA PATEREK APN
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Gender | Female
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 425 JACK MARTIN BLVD
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City | BRICK
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State | NJ
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Zip | 08724-7732
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Country | US
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Telephone | 732-836-4854
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Fax |
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS RD BLDG 2, STE 220
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City | RED BANK
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State | NJ
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Zip | 07701-5688
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00759100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ00759100
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License Number State | NJ
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