Healthcare Provider Details

I. General information

NPI: 1770556631
Provider Name (Legal Business Name): JAMES L RYCYNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 WEHRLE DRIVE
WILLIAMSVILLE NY
14221-1718
US

IV. Provider business mailing address

825 WEHRLE DRIVE
WILLIAMSVILLE NY
14221-1718
US

V. Phone/Fax

Practice location:
  • Phone: 716-634-3502
  • Fax: 716-634-1930
Mailing address:
  • Phone: 716-634-3502
  • Fax: 716-634-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number162368-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: