Provider Demographics
NPI:1881846970
Name:RILEY, JANE W (PT DPT MS PCS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:W
Last Name:RILEY
Suffix:
Gender:F
Credentials:PT DPT MS PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 BOSTON POST RD APT 8
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2963
Mailing Address - Country:US
Mailing Address - Phone:914-374-5786
Mailing Address - Fax:914-880-0082
Practice Address - Street 1:1085 BOSTON POST RD APT 8
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2963
Practice Address - Country:US
Practice Address - Phone:914-374-5786
Practice Address - Fax:914-395-1923
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0185972251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02810497Medicaid