Provider Demographics
NPI:1104817865
Name:RINEY, PEARL A (MD)
Entity type:Individual
Prefix:
First Name:PEARL
Middle Name:A
Last Name:RINEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PEARL
Other - Middle Name:A
Other - Last Name:SCHLOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:DIVISION OF PEDIATRICS DOWLING 3 SOUTH
Mailing Address - Street 2:ONE BOSTON MEDICAL CENTER PLACE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:617-414-5170
Mailing Address - Fax:617-414-3803
Practice Address - Street 1:CHILD HEALTH FOUNDATION OF BOSTON
Practice Address - Street 2:DOWLING 3 SOUTH ONE BOSTON MEDICAL CENTER PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-5170
Practice Address - Fax:617-414-3803
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223842208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2107023Medicaid
A38611Medicare ID - Type Unspecified
MA2107023Medicaid