Healthcare Provider Details

I. General information

NPI: 1609704493
Provider Name (Legal Business Name): JANIYA RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2581 ATLANTIC AVE
BROOKLYN NY
11207-2412
US

IV. Provider business mailing address

47 MALTA ST APT 3B
BROOKLYN NY
11207-6731
US

V. Phone/Fax

Practice location:
  • Phone: 718-495-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number126088
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: