Provider Demographics
NPI:1669469201
Name:RYCHAK, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:RYCHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:99 NOVEMBER DR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-5064
Mailing Address - Country:US
Mailing Address - Phone:717-901-8000
Mailing Address - Fax:717-761-6860
Practice Address - Street 1:99 NOVEMBER DR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-5064
Practice Address - Country:US
Practice Address - Phone:717-901-8000
Practice Address - Fax:717-761-6860
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013473E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000675917-0003Medicaid
PA032385D02Medicare ID - Type Unspecified
PA000675917-0003Medicaid