Provider Demographics
NPI:1679173058
Name:RILEY, DONNA MARIA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIA
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 1:350 GALLOWAY ST NE APT 206
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6374
Mailing Address - Country:US
Mailing Address - Phone:347-385-4346
Mailing Address - Fax:
Practice Address - Street 1:350 GALLOWAY ST NE APT 206
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6374
Practice Address - Country:US
Practice Address - Phone:347-385-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant