Healthcare Provider Details

I. General information

NPI: 1295930980
Provider Name (Legal Business Name): MARY ELLEN RIMSZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 S 3RD ST
PHOENIX AZ
85004-2506
US

IV. Provider business mailing address

9885 N 131ST PL
SCOTTSDALE AZ
85259-5324
US

V. Phone/Fax

Practice location:
  • Phone: 602-254-5921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number9981
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: