Provider Demographics
NPI:1609488485
Name:DHUNGEL, RAYAAN
Entity Type:Individual
Prefix:
First Name:RAYAAN
Middle Name:
Last Name:DHUNGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 GREEN RIDGE ST # 1
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1908
Mailing Address - Country:US
Mailing Address - Phone:570-316-5085
Mailing Address - Fax:
Practice Address - Street 1:814 GREEN RIDGE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1908
Practice Address - Country:US
Practice Address - Phone:570-316-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30729570332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies