Provider Demographics
NPI:1982972253
Name:RILEY, DIANE CATHERINE (RN)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:CATHERINE
Last Name:RILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12202-1301
Mailing Address - Country:US
Mailing Address - Phone:518-475-6482
Mailing Address - Fax:
Practice Address - Street 1:45 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-1301
Practice Address - Country:US
Practice Address - Phone:518-475-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321562-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool