Provider Demographics
NPI:1346451267
Name:RILEY, MARGARET M (PNP, FNP, MSN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:RILEY
Suffix:
Gender:F
Credentials:PNP, FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1314
Mailing Address - Country:US
Mailing Address - Phone:631-321-2100
Mailing Address - Fax:631-321-2246
Practice Address - Street 1:655 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1314
Practice Address - Country:US
Practice Address - Phone:631-321-2100
Practice Address - Fax:631-321-2246
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331231363LF0000X
NYF380490363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily