Provider Demographics
NPI:1477512739
Name:RYCYNA, STEPHEN D JR (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:RYCYNA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5771
Mailing Address - Country:US
Mailing Address - Phone:716-631-3555
Mailing Address - Fax:716-250-4177
Practice Address - Street 1:3925 SHERIDAN DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-0000
Practice Address - Country:US
Practice Address - Phone:716-250-9999
Practice Address - Fax:716-250-4177
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1237671207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC49578Medicare UPIN
NYCC8848Medicare PIN