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General NPI Number Information
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NPI Number | 1710301890
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Entity Type | Individual
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Provider Name | JULIE RYBITSKIY PA
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Gender | Female
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Dates
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Enumeration Date | 02/11/2014
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 760 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11206-5317
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Country | US
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Telephone | 718-963-7906
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N BISHOP AVE APT 434
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City | DALLAS
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State | TX
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Zip | 75208-1374
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Country | US
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Telephone | 347-421-1499
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 017290
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License Number State | NY
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