Individual
DR. KENNETH MICHAEL RALTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655
(508) 856-3155
(508) 856-3111
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
265176
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
265176
MA
207RN0300X
Nephrology Physician
Primary
265176
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110124521A
—
MA
Enumeration date
06/02/2011
Last updated
07/28/2021
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