Basic Information
Provider Information
NPI: 1902330954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RATAY
FirstName: MARY KATHLEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 IRVING ST NW
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028778080
FaxNumber: 2028777633
Practice Location
Address1: 110 IRVING ST NW
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028778080
FaxNumber: 2028777633
Other Information
ProviderEnumerationDate: 04/17/2017
LastUpdateDate: 04/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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