Healthcare Provider Details

I. General information

NPI: 1952305997
Provider Name (Legal Business Name): CATHERINE ANNE RIORDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 CHANDLER ST
WORCESTER MA
01602-2915
US

IV. Provider business mailing address

421 CHANDLER ST
WORCESTER MA
01602-2915
US

V. Phone/Fax

Practice location:
  • Phone: 508-752-4511
  • Fax: 508-797-4729
Mailing address:
  • Phone: 508-752-4511
  • Fax: 508-797-4729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number80757
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: