Healthcare Provider Details

I. General information

NPI: 1871424473
Provider Name (Legal Business Name): MCLAINE RILEY RUTAN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 E MAIN ST
MIDDLETOWN CT
06457-3835
US

IV. Provider business mailing address

94 STEVENSTOWN RD
DEEP RIVER CT
06417-1508
US

V. Phone/Fax

Practice location:
  • Phone: 833-354-1492
  • Fax:
Mailing address:
  • Phone: 860-391-5547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: