Provider Demographics
NPI:1073175915
Name:RILEY, PAIGE WINTER (OTR)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:WINTER
Last Name:RILEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 PUTNAM RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1034
Mailing Address - Country:US
Mailing Address - Phone:312-231-8407
Mailing Address - Fax:
Practice Address - Street 1:127 CAMBRIDGE ST STE 2B
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3735
Practice Address - Country:US
Practice Address - Phone:781-272-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA011217225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist