Provider Demographics
NPI:1679088280
Name:STEELE, RILEY M
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:M
Last Name:STEELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-3716
Mailing Address - Country:US
Mailing Address - Phone:774-276-0708
Mailing Address - Fax:
Practice Address - Street 1:96 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-3716
Practice Address - Country:US
Practice Address - Phone:774-276-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program