Provider Demographics
NPI:1598721813
Name:RILEY, NANCY (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10475 READING RD
Mailing Address - Street 2:STE. 405
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2563
Mailing Address - Country:US
Mailing Address - Phone:513-585-9600
Mailing Address - Fax:513-585-9668
Practice Address - Street 1:10475 READING RD
Practice Address - Street 2:STE. 405
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2563
Practice Address - Country:US
Practice Address - Phone:513-585-9600
Practice Address - Fax:513-585-9668
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069909H207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2077112Medicaid
KY64096456Medicaid
OH2077112Medicaid
OH0855363Medicare PIN