Provider Demographics
NPI:1033514013
Name:OBRYCKA, MARIA ANNA (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANNA
Last Name:OBRYCKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ANNA
Other - Last Name:GODLEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:943 LORIMER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-3103
Mailing Address - Country:US
Mailing Address - Phone:917-331-4172
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L. LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-7344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307020363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health