Provider Demographics
NPI:1679523799
Name:ZEBRAK, RYSZARD (MD)
Entity type:Individual
Prefix:
First Name:RYSZARD
Middle Name:
Last Name:ZEBRAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 KENNEDY LN
Mailing Address - Street 2:BLDG. 100
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6016
Mailing Address - Country:US
Mailing Address - Phone:540-741-7100
Mailing Address - Fax:540-741-7103
Practice Address - Street 1:12000 KENNEDY LN
Practice Address - Street 2:BLDG. 100
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6016
Practice Address - Country:US
Practice Address - Phone:540-741-7100
Practice Address - Fax:540-741-7103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012360772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry