Individual
DIANE M RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1020 THOMPSON ST, JERSEY SHORE, PA 17740-1729
(570) 398-5131
(570) 398-3195
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
202042
NY
207L00000X
Anesthesiology Physician
25MA07775800
NJ
207L00000X
Anesthesiology Physician
Primary
MD477014
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077640
—
NJ
01
—
P00953293
RR MCR PTAN
NJ
Enumeration date
01/15/2006
Last updated
03/16/2022
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