Provider Demographics
NPI:1518596733
Name:TSYRLIN, REBECCA FAYE (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:FAYE
Last Name:TSYRLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:FAYE
Other - Last Name:SHRAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2655 DALLAS HWY SW STE 340
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-7518
Mailing Address - Country:US
Mailing Address - Phone:678-797-9800
Mailing Address - Fax:
Practice Address - Street 1:2655 DALLAS HWY SW STE 340
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-7518
Practice Address - Country:US
Practice Address - Phone:678-797-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical