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General NPI Number Information
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NPI Number | 1417915133
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Entity Type | Individual
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Provider Name | MAUREEN RYALL M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 101 PAGE STREET ST. LUKE'S HOSPITAL
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City | NEW BEDFORD
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State | MA
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Zip | 02740
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Country | US
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Telephone | 508-961-5598
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Fax |
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Provider Business Mailing Address
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Address Line | 165 COLUMBIA LN
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City | JAMESTOWN
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State | RI
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Zip | 02835-1813
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Country | US
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Telephone | 508-961-5598
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 78616
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License Number State | MA
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