Provider Demographics
NPI:1952305997
Name:RIORDAN, CATHERINE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNE
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2915
Mailing Address - Country:US
Mailing Address - Phone:508-752-4511
Mailing Address - Fax:508-797-4729
Practice Address - Street 1:421 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2915
Practice Address - Country:US
Practice Address - Phone:508-752-4511
Practice Address - Fax:508-797-4729
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9774343Medicaid
MA9774343Medicaid