Healthcare Provider Details

I. General information

NPI: 1033187919
Provider Name (Legal Business Name): CRYSTAL L RAINVILLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N MAIN ST
ATTLEBORO MA
02703-1752
US

IV. Provider business mailing address

303 N MAIN ST
ATTLEBORO MA
02703-1752
US

V. Phone/Fax

Practice location:
  • Phone: 508-236-0100
  • Fax: 508-342-1921
Mailing address:
  • Phone: 508-236-0100
  • Fax: 508-342-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number157612
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: