Provider Demographics
NPI:1245789841
Name:RIKER, SHERI
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:RIKER
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 1:37 CORRIEDALE LN
Mailing Address - Street 2:
Mailing Address - City:COTTEKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12419-5029
Mailing Address - Country:US
Mailing Address - Phone:845-417-7420
Mailing Address - Fax:
Practice Address - Street 1:520 WHITE PLAINS RD
Practice Address - Street 2:SUITE 500
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5102
Practice Address - Country:US
Practice Address - Phone:800-403-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-25
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30307966363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health