Healthcare Provider Details

I. General information

NPI: 1609730530
Provider Name (Legal Business Name): RAYNA MEDEIROS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 FAUNCE CORNER RD STE 102
NORTH DARTMOUTH MA
02747-1271
US

IV. Provider business mailing address

4 RICHMOND SQ
PROVIDENCE RI
02906-5117
US

V. Phone/Fax

Practice location:
  • Phone: 508-501-0920
  • Fax: 508-501-0913
Mailing address:
  • Phone: 401-433-4172
  • Fax: 401-433-0612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL88724
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: