=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609730530
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAYNA MEDEIROS PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2025
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 FAUNCE CORNER RD STE 102
-----------------------------------------------------
City | NORTH DARTMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02747-1271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-501-0920
-----------------------------------------------------
Fax | 508-501-0913
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 RICHMOND SQ
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02906-5117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-433-4172
-----------------------------------------------------
Fax | 401-433-0612
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PTL88724
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------