Provider Demographics
NPI:1881584225
Name:RIDLEY, SENECA (MED)
Entity type:Individual
Prefix:
First Name:SENECA
Middle Name:
Last Name:RIDLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 OVERBEY DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6208
Mailing Address - Country:US
Mailing Address - Phone:614-800-6243
Mailing Address - Fax:
Practice Address - Street 1:3400 OVERBEY DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-6208
Practice Address - Country:US
Practice Address - Phone:614-800-6243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals