Provider Demographics
NPI:1982750543
Name:RYBCZYNSKI, SUZANNE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:RYBCZYNSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:PRESTWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2931 E. BIDDLE ST
Mailing Address - Street 2:PATIENT ACCOUNTING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213
Mailing Address - Country:US
Mailing Address - Phone:443-923-1872
Mailing Address - Fax:
Practice Address - Street 1:707 N. BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205
Practice Address - Country:US
Practice Address - Phone:443-923-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64380208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBV5751284OtherDEA #
MDD80245Medicare UPIN