Basic Information
| Provider Information | |||||||||
| NPI: | 1508882234 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RYLKO | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 E. BROWN ST. | ||||||||
| Address2: | POCONO HEALTHCARE MANAGEMENT-PROFESSIONAL CENTER | ||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183013006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704204951 | ||||||||
| FaxNumber: | 5704763754 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 PLAZA COURT, SUITE A | ||||||||
| Address2: | PMC PHYSICIAN ASSOCIATES CARDIOLOGY | ||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183018262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704249970 | ||||||||
| FaxNumber: | 5704242899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 11/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD039907E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0012790240005 | 05 | PA | MEDICAID | 1134123 | 01 | PA | AMERIHEALTH MERCY | OTHER | 4277151 | 01 | PA | AETNA DR RYLKO PROVIDER # | OTHER | 076216 | 01 | PA | FIRST PRIORITY | OTHER | 1185412 | 01 | PA | CIGNA | OTHER | 814175 | 01 | PA | AETNA GROUP NUMBER | OTHER | 23237 | 01 | PA | GEISINGER | OTHER | 6014195 | 01 | PA | GHI | OTHER | 012130 | 01 | PA | BCBS HIGHMARK | OTHER |