MEDICARE: MS. SVITLANA TYMCHUK PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	25MP00924200	NJ

General Provider Information

NPI Number	:	1962108035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SVITLANA TYMCHUK PA-C

Provider Business Mailing Address
First Line	:	1001 CLIFTON AVE STE 2A
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3586
Country	:	US
Telephone Number	:	732-698-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 CLIFTON AVE STE 2A
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-3586
Country	:	US
Telephone Number	:	732-698-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	12/15/2025

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