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NPI Code Detail

MEDICARE: ALICE E RIDEN MD

MEDICARE: ALICE E RIDEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD033952EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962444877
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE E RIDEN MD
Provider Business Mailing Address
First Line : 6 W NEWPORT RD
Second Line :
City : LITITZ
State : PA
Zip : 17543-7774
Country : US
Telephone Number : 717-627-2108
Fax Number :
Provider Business Practice Location Address
First Line : 6 W NEWPORT RD
Second Line :
City : LITITZ
State : PA
Zip : 17543-7774
Country : US
Telephone Number : 717-627-2108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 09/06/2011

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Directions to “ ALICE E RIDEN MD” Practice Location

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