Individual
JEFFREY KEVIN RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
955 5TH AVE, NEW YORK, NY 10075-1738
(212) 734-9949
(212) 734-9894
Mailing address
2124 E 72ND ST, BROOKLYN, NY 11234-6229
(718) 986-4616
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
028598
—
363AS0400X
Surgical Physician Assistant
Primary
028598
NY
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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