Provider Demographics
NPI:1043676539
Name:LARAMORE, RILEY (PA-C)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:LARAMORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412503
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2503
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 CENTURY PINES DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825-3732
Practice Address - Country:US
Practice Address - Phone:603-664-2135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA9494363A00000X
NH1146363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant