Healthcare Provider Details

I. General information

NPI: 1497756894
Provider Name (Legal Business Name): RICARDO B. RAYMUNDO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 PERRY HWY UNIT #2
HARMONY PA
16037-9247
US

IV. Provider business mailing address

1350 LOCUST ST SUITE 100
PITTSBURGH PA
15219-4738
US

V. Phone/Fax

Practice location:
  • Phone: 724-452-9260
  • Fax: 724-452-9207
Mailing address:
  • Phone: 412-562-3292
  • Fax: 412-281-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD034287L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: