Provider Demographics
NPI:1275418428
Name:RICEWOOLF, BRYCE
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:RICEWOOLF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COTTAGE ST # AT3
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4351
Mailing Address - Country:US
Mailing Address - Phone:443-822-8909
Mailing Address - Fax:
Practice Address - Street 1:14 COTTAGE ST # AT3
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4351
Practice Address - Country:US
Practice Address - Phone:443-822-8909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program