Individual
THOMAS JUDE RILEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5 HDSN VLY PROF PLZ, NEWBURGH, NY 12550-3150
(845) 595-4775
Mailing address
5 HDSN VLY PROF PLZ, NEWBURGH, NY 12550-3150
(845) 575-4775
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382056-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470157-1
REGISTERED PROFESSIONAL NURSE
NY
01
—
F382056-1
NURSE PRACTITIONER
NY
Enumeration date
03/05/2019
Last updated
03/05/2019
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