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Individual

DR. KENNETH D RILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
50 MONTGOMERY ST, CANAJOHARIE, NY 13317
(518) 673-5555
(518) 673-5761
Mailing address
PO BOX 725, COOPERSTOWN, NY 13326-0725
(518) 673-5555
(518) 673-5761

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
182664
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02073169
NY
Enumeration date
05/13/2006
Last updated
03/28/2008
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