Provider Demographics
NPI:1861216947
Name:RILEY, NATHANIEL
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:
Last Name:RILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 K ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:NW
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1629 K ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:NW
Practice Address - State:DC
Practice Address - Zip Code:20002-3396
Practice Address - Country:US
Practice Address - Phone:240-758-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator