Provider Demographics
NPI:1831534825
Name:DR ROBERT RIORDAN-CLINICAL PSYCHOLOGIST PLLC
Entity type:Organization
Organization Name:DR ROBERT RIORDAN-CLINICAL PSYCHOLOGIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RIORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:212-203-3118
Mailing Address - Street 1:257 W 117TH ST
Mailing Address - Street 2:4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2185
Mailing Address - Country:US
Mailing Address - Phone:212-203-3118
Mailing Address - Fax:
Practice Address - Street 1:240 W END AVE
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-0135
Practice Address - Country:US
Practice Address - Phone:212-203-3118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019637103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty