Provider Demographics
NPI:1942647953
Name:RYBAK, ELANA RACHEL (DVM)
Entity Type:Individual
Prefix:DR
First Name:ELANA
Middle Name:RACHEL
Last Name:RYBAK
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 N CALVERT ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3730
Mailing Address - Country:US
Mailing Address - Phone:517-285-0041
Mailing Address - Fax:
Practice Address - Street 1:10 S PINE ST
Practice Address - Street 2:MSTF BLDG, ROOM 469
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1116
Practice Address - Country:US
Practice Address - Phone:410-706-1164
Practice Address - Fax:410-706-0311
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6670174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6670OtherVETERINARY LICENSE NUMBER