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Individual

MARK RYDZEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5804 61ST ST, MASPETH, NY 11378-2811
(718) 894-9156
(718) 692-8569
Mailing address
5804 61ST ST, MASPETH, NY 11378-2811
(718) 894-9156
(718) 692-8569

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
185061
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01477861
NY
01
110167260
RAILROAD
NY
Enumeration date
11/01/2006
Last updated
02/27/2009
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