| Riso Medical P.c. | |
|
8014 13th Ave Brooklyn NY 11228-3002 | |
| (347) 635-4461 | |
| Not Available |
| Full Name | Riso Medical P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8014 13th Ave, Brooklyn, New York |
| Authorized Official Name and Position | Stephen L Riso (PRESIDENT) |
| Authorized Official Contact | 3476354461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riso Medical P.c. 399 Loretto St Staten Island NY 10307-2202 Ph: (347) 635-4461 | Riso Medical P.c. 8014 13th Ave Brooklyn NY 11228-3002 Ph: (347) 635-4461 |
| NPI Number | 1437523420 |
|---|---|
| Provider Enumeration Date | 11/14/2015 |
| Last Update Date | 08/05/2022 |
| Medicare PECOS PAC ID | 7517259294 |
|---|---|
| Medicare Enrollment ID | O20160718000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437523420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 271041 (New York) | Primary |
| Provider Name | Stephen L Riso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639498959 PECOS PAC ID: 0143460048 Enrollment ID: I20130716000784 |
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