Provider Demographics
NPI:1124216585
Name:RATTAY, KARYL T (MD)
Entity Type:Individual
Prefix:DR
First Name:KARYL
Middle Name:T
Last Name:RATTAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 FEDERAL STREET
Mailing Address - Street 2:DELAWARE DIVISION OF PUBLIC HEALTH
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-744-4818
Mailing Address - Fax:302-739-6659
Practice Address - Street 1:417 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3635
Practice Address - Country:US
Practice Address - Phone:302-744-4818
Practice Address - Fax:302-739-6659
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007731208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0151718Medicaid
MD4140354Medicaid
G17127Medicare UPIN