Healthcare Provider Details

I. General information

NPI: 1033747043
Provider Name (Legal Business Name): BRADLEY RYBINSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W WASHINGTON SQUARE
PHILADELPHIA PA
19106-3500
US

IV. Provider business mailing address

22 S GREENE ST RM N3E09
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-6088
  • Fax:
Mailing address:
  • Phone: 410-328-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD493519
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: