Provider Demographics
NPI:1881955391
Name:RILEY, TANGELA
Entity type:Individual
Prefix:
First Name:TANGELA
Middle Name:
Last Name:RILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 16TH ST NW
Mailing Address - Street 2:APT # 51
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3358
Mailing Address - Country:US
Mailing Address - Phone:202-745-3930
Mailing Address - Fax:
Practice Address - Street 1:3150 16TH ST NW
Practice Address - Street 2:APT # 51
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3358
Practice Address - Country:US
Practice Address - Phone:202-745-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide