Provider Demographics
NPI:1225532765
Name:RIEHLE, CAROLYNE (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYNE
Middle Name:
Last Name:RIEHLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8031
Mailing Address - Country:US
Mailing Address - Phone:860-679-7687
Mailing Address - Fax:860-679-0131
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8031
Practice Address - Country:US
Practice Address - Phone:860-679-7687
Practice Address - Fax:860-679-0131
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12695693-1204207W00000X, 207WX0109X
390200000X
CT0757322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program