Healthcare Provider Details

I. General information

NPI: 1669469201
Provider Name (Legal Business Name): JOHN S RYCHAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NOVEMBER DR
CAMP HILL PA
17011-5064
US

IV. Provider business mailing address

99 NOVEMBER DR
CAMP HILL PA
17011-5064
US

V. Phone/Fax

Practice location:
  • Phone: 717-901-8000
  • Fax: 717-761-6860
Mailing address:
  • Phone: 717-901-8000
  • Fax: 717-761-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD013473E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: