Healthcare Provider Details

I. General information

NPI: 1033144886
Provider Name (Legal Business Name): MARIA RIORDAN MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NP 502 PLZ
MOSCOW PA
18444-9266
US

IV. Provider business mailing address

918 GREENFIELD RD
MOSCOW PA
18444-8621
US

V. Phone/Fax

Practice location:
  • Phone: 570-848-1240
  • Fax: 570-848-1243
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-007042L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: