Healthcare Provider Details

I. General information

NPI: 1932775491
Provider Name (Legal Business Name): RAMSHA RIAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date: 11/28/2022
Reactivation Date: 07/12/2024

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

IV. Provider business mailing address

100 N ACADEMY AVE DEPT OF
DANVILLE PA
17822-0001
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6211
  • Fax:
Mailing address:
  • Phone: 570-271-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMT231368
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: