Provider Demographics
NPI:1114534625
Name:RYBAK, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:RYBAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MCKNIGHT EAST DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6422
Mailing Address - Country:US
Mailing Address - Phone:412-295-6734
Mailing Address - Fax:412-837-1290
Practice Address - Street 1:3000 MCKNIGHT EAST DR STE 102
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6422
Practice Address - Country:US
Practice Address - Phone:412-295-6734
Practice Address - Fax:412-837-1290
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARBT-20-136253106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician