Provider Demographics
NPI:1386618700
Name:RIKER, LORRAINE (ANPC)
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:
Last Name:RIKER
Suffix:
Gender:F
Credentials:ANPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1857 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-5219
Mailing Address - Country:US
Mailing Address - Phone:732-714-2707
Mailing Address - Fax:
Practice Address - Street 1:17 BROAD ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1703
Practice Address - Country:US
Practice Address - Phone:732-462-9622
Practice Address - Fax:732-780-0014
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04288700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7037104Medicaid
NJ7037104Medicaid
NJ143819ZEL1Medicare PIN