Provider Demographics
NPI:1902313307
Name:RILEY, KRISTEN E (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:RILEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2362
Mailing Address - Country:US
Mailing Address - Phone:484-459-2004
Mailing Address - Fax:
Practice Address - Street 1:152 FRELINGHUYSEN RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8020
Practice Address - Country:US
Practice Address - Phone:484-459-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022474103TC0700X
NJ6046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical