Provider Demographics
NPI:1063884401
Name:RIERAS, MAUREEN S (MS, CNS, LDN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:S
Last Name:RIERAS
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 WILLARD AVE APT 1110
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4624
Mailing Address - Country:US
Mailing Address - Phone:773-510-6266
Mailing Address - Fax:
Practice Address - Street 1:4701 WILLARD AVE APT 1110
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4624
Practice Address - Country:US
Practice Address - Phone:773-510-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3681133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist