Provider Demographics
NPI:1659766541
Name:RILEY, RAYMOND Z (PA-C)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:Z
Last Name:RILEY
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2209C DEFENSE HWY
Mailing Address - Street 2:APT. N
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2403
Mailing Address - Country:US
Mailing Address - Phone:443-332-4260
Mailing Address - Fax:888-721-8040
Practice Address - Street 1:295 STONER AVE STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5662
Practice Address - Country:US
Practice Address - Phone:410-848-1818
Practice Address - Fax:410-871-7964
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2024-10-07
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Provider Licenses
StateLicense IDTaxonomies
MDC05750363A00000X
NC0010-05662363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant