Provider Demographics
NPI:1487662151
Name:VALIYIL, RITU (MD)
Entity Type:Individual
Prefix:
First Name:RITU
Middle Name:
Last Name:VALIYIL
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 1:110 FRANCIS ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5501
Mailing Address - Country:US
Mailing Address - Phone:617-632-8658
Mailing Address - Fax:617-632-7514
Practice Address - Street 1:110 FRANCIS ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5501
Practice Address - Country:US
Practice Address - Phone:617-632-8658
Practice Address - Fax:617-632-7514
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA228399207R00000X, 207RR0500X
PAMD440390207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine