Provider Demographics
NPI:1205538238
Name:RYABICHEVA, TSILISTINA
Entity type:Individual
Prefix:
First Name:TSILISTINA
Middle Name:
Last Name:RYABICHEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1304
Mailing Address - Country:US
Mailing Address - Phone:917-496-5466
Mailing Address - Fax:
Practice Address - Street 1:3730 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1304
Practice Address - Country:US
Practice Address - Phone:917-496-5466
Practice Address - Fax:718-373-1386
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY494446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse