Provider Demographics
NPI:1013550110
Name:TRYBA, RACHEL JEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JEAN
Last Name:TRYBA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-3326
Mailing Address - Country:US
Mailing Address - Phone:413-302-1594
Mailing Address - Fax:
Practice Address - Street 1:46 WARREN ST
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-3326
Practice Address - Country:US
Practice Address - Phone:413-302-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant