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General NPI Number Information
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NPI Number | 1528498805
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Entity Type | Organization
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Legal Business Name | MAYER I. RYDZINSKI MD PC
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 7020 YELLOWSTONE BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375-3500
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Country | US
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Telephone | 516-773-3855
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Fax |
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Provider Business Mailing Address
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Address Line | 32 CEDAR DR
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City | GREAT NECK
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State | NY
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Zip | 11021-1932
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Country | US
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Telephone | 516-773-3855
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAYER I. RYDZINSKI
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Credential | MD
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Telephone | 718-268-7633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 131957
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License Number State | NY
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