Basic Information
| Provider Information | |||||||||
| NPI: | 1922019256 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RYNSKI | ||||||||
| FirstName: | FELIX | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1002 ELK STREET | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144322091 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 12TH ST | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163231217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144373071 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 09/19/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0C005519L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0018718060001 | 05 | PA | MEDICAID | 001785770 | 01 | PA | BLUE SHIELD | OTHER |