Provider Demographics
NPI:1891982930
Name:CYBAK, DENISE (LMT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:CYBAK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CLAIRE PL
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4613
Mailing Address - Country:US
Mailing Address - Phone:302-998-6547
Mailing Address - Fax:
Practice Address - Street 1:720 YORKLYN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8728
Practice Address - Country:US
Practice Address - Phone:302-234-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0001340174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist