Provider Demographics
NPI:1255852224
Name:RISAL, RUBY (MD)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:RISAL
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2790
Mailing Address - Fax:717-339-2771
Practice Address - Street 1:40 V TWIN DR STE 205
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7878
Practice Address - Country:US
Practice Address - Phone:717-339-2790
Practice Address - Fax:717-339-2771
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD477158207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease