Provider Demographics
NPI:1457556631
Name:RIEDMAN, CATHY LEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:LEE
Last Name:RIEDMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:NY
Mailing Address - Zip Code:14568-9744
Mailing Address - Country:US
Mailing Address - Phone:315-524-8874
Mailing Address - Fax:
Practice Address - Street 1:2127 1ST AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-9716
Practice Address - Country:US
Practice Address - Phone:315-524-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071441-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse