Healthcare Provider Details

I. General information

NPI: 1861590812
Provider Name (Legal Business Name): RONALD J. RIMALI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 OLD DOANSBURG LN
BREWSTER NY
10509-4911
US

IV. Provider business mailing address

9 OLD DOANSBURG LN
BREWSTER NY
10509-4911
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-0924
  • Fax:
Mailing address:
  • Phone: 845-278-0924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005178
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: