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General NPI Number Information
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NPI Number | 1578204020
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Entity Type | Individual
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Provider Name | JOSHUA M RILEY
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Gender | Male
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 3509 N BROAD ST FL 4
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4105
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Country | US
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Telephone | 717-979-8108
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Fax |
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Provider Business Mailing Address
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Address Line | 342 WESTVIEW DR
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-9428
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Country | US
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Telephone | 717-979-8108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MT225439
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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