Provider Demographics
NPI:1285839845
Name:MAITLAND, RALYNNE ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:RALYNNE
Middle Name:ELIZABETH
Last Name:MAITLAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BRUNSWICK AVE
Mailing Address - Street 2:CAPITAL HEALTH - DEPT. OF EM
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-4143
Mailing Address - Country:US
Mailing Address - Phone:609-815-7091
Mailing Address - Fax:
Practice Address - Street 1:750 BRUNSWICK AVE
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-4143
Practice Address - Country:US
Practice Address - Phone:609-815-7091
Practice Address - Fax:609-815-7886
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09032900207PP0204X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine