Provider Demographics
NPI:1760400766
Name:RYBERG & RYBERG, PC
Entity Type:Organization
Organization Name:RYBERG & RYBERG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:RYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:248-895-6206
Mailing Address - Street 1:30247 OVERDALE COURT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-895-6206
Mailing Address - Fax:248-357-4447
Practice Address - Street 1:28336 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-5503
Practice Address - Country:US
Practice Address - Phone:248-895-6206
Practice Address - Fax:248-357-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION48610Medicare PIN