Provider Demographics
NPI:1417484577
Name:RILEY-GIOMARISO, OMA MAE (CRNP)
Entity Type:Individual
Prefix:DR
First Name:OMA
Middle Name:MAE
Last Name:RILEY-GIOMARISO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 GLENEAGLES DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1115
Mailing Address - Country:US
Mailing Address - Phone:717-767-6426
Mailing Address - Fax:
Practice Address - Street 1:1045 GLENEAGLES DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1115
Practice Address - Country:US
Practice Address - Phone:717-767-6426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000530B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily