Healthcare Provider Details

I. General information

NPI: 1225759343
Provider Name (Legal Business Name): VICTORIA BYBEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 EASTBROOK RD
RONKS PA
17572-9769
US

IV. Provider business mailing address

2268 WILLIAM PENN WAY
LANCASTER PA
17601-6731
US

V. Phone/Fax

Practice location:
  • Phone: 717-431-3000
  • Fax:
Mailing address:
  • Phone: 717-727-3558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP026100
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: