Healthcare Provider Details

I. General information

NPI: 1922330042
Provider Name (Legal Business Name): KEVIN RYCYNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 04/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DELAFIELD RD STE 3060 SUITE 3060
PITTSBURGH PA
15215-3235
US

IV. Provider business mailing address

200 DELAFIELD RD STE 3060 SUITE 3060
PITTSBURGH PA
15215-3235
US

V. Phone/Fax

Practice location:
  • Phone: 412-781-6448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD467044
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: