Healthcare Provider Details

I. General information

NPI: 1861396848
Provider Name (Legal Business Name): LAUREN RIKER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 THURBER DR
WATERLOO NY
13165-1665
US

IV. Provider business mailing address

3643 NUMBER 9 RD
GENEVA NY
14456-9109
US

V. Phone/Fax

Practice location:
  • Phone: 315-539-1980
  • Fax:
Mailing address:
  • Phone: 315-651-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408604
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: