Provider Demographics
NPI:1033144886
Name:RIORDAN, MARIA (MSPT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-8621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 NP 502 PLZ
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-9266
Practice Address - Country:US
Practice Address - Phone:570-848-1240
Practice Address - Fax:570-848-1243
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-007042L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0507505000OtherINDEPENDENCE BLUE CROSS
PA076038OtherFIRST PRIORITY HEALTH
PA674174OtherBLUE SHIELD
PA546174OtherAETNA
PA50017299OtherCAPITAL BLUE CROSS