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General NPI Number Information
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NPI Number | 1609945369
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Entity Type | Organization
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Legal Business Name | THOMAS S RYSCAVAGE, MD, PC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2200 S GEORGE ST SUITE W-2
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City | YORK
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State | PA
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Zip | 17403-4594
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Country | US
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Telephone | 717-741-4653
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Fax | 717-741-6803
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Provider Business Mailing Address
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Address Line | 2200 S GEORGE ST SUITE W-2
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City | YORK
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State | PA
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Zip | 17403-4594
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Country | US
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Telephone | 717-741-4653
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Fax | 717-741-6803
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS S RYSCAVAGE
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Credential | MD
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Telephone | 717-741-4653
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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 | MD036084L
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License Number State | PA
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