Provider Demographics
NPI:1225014285
Name:RIORDAN, IRENE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:ANN
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8815 GERMANTOWN AVE
Mailing Address - Street 2:STE. 40
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2722
Mailing Address - Country:US
Mailing Address - Phone:215-248-3100
Mailing Address - Fax:215-248-3971
Practice Address - Street 1:8815 GERMANTOWN AVE
Practice Address - Street 2:STE. 40
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2722
Practice Address - Country:US
Practice Address - Phone:215-248-3100
Practice Address - Fax:215-248-3971
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMW008579L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP99181Medicare UPIN