Provider Demographics
NPI:1245215169
Name:RILEY, DANIEL FRANCIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANCIS
Last Name:RILEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 POND ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-6853
Mailing Address - Country:US
Mailing Address - Phone:781-848-9978
Mailing Address - Fax:781-848-7773
Practice Address - Street 1:409 POND ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6850
Practice Address - Country:US
Practice Address - Phone:781-848-9978
Practice Address - Fax:781-848-7773
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1648213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y70765Medicare ID - Type Unspecified
MAT57934Medicare UPIN