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General NPI Number Information
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NPI Number | 1639766975
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Entity Type | Organization
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Legal Business Name | BRIDGETTE L. RILEY, NP IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 600 MAMARONECK AVE STE 400
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City | HARRISON
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State | NY
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Zip | 10528-1613
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Country | US
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Telephone | 914-301-9469
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Fax | 877-514-2934
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Provider Business Mailing Address
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Address Line | 108 VILLAGE SQ # 197
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City | SOMERS
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State | NY
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Zip | 10589-2305
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KEVIN LEWIS
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Credential |
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Telephone | 914-523-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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