Provider Demographics
NPI:1548603285
Name:RILEY, MARIA PATRICIA (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:PATRICIA
Last Name:RILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 LEE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-8736
Mailing Address - Country:US
Mailing Address - Phone:315-351-6868
Mailing Address - Fax:
Practice Address - Street 1:4941 LEE VALLEY RD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-8736
Practice Address - Country:US
Practice Address - Phone:315-351-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse