Provider Demographics
NPI:1780467019
Name:RYCZEK, MARIA ENRIQUETA (CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ENRIQUETA
Last Name:RYCZEK
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ELISE WAY
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7646
Mailing Address - Country:US
Mailing Address - Phone:570-807-6320
Mailing Address - Fax:
Practice Address - Street 1:112 ELISE WAY
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7646
Practice Address - Country:US
Practice Address - Phone:570-807-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine