Provider Demographics
NPI:1982475521
Name:TRYBALA, ELZBIETA (WHNP - BC)
Entity type:Individual
Prefix:
First Name:ELZBIETA
Middle Name:
Last Name:TRYBALA
Suffix:
Gender:F
Credentials:WHNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1300
Mailing Address - Country:US
Mailing Address - Phone:631-376-3232
Mailing Address - Fax:
Practice Address - Street 1:661 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1300
Practice Address - Country:US
Practice Address - Phone:631-376-3232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF421660363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health