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General NPI Number Information
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NPI Number | 1013510478
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Entity Type | Individual
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Provider Name | JAIME LYNN RYBKA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1 DAVIS SQ
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City | SOMERVILLE
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State | MA
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Zip | 02144-2904
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Country | US
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Telephone | 671-629-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BETHEL RD APT 8
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City | WELLESLEY
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State | MA
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Zip | 02481-3533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH239336
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License Number State | MA
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