Riesa, Michael
Riesa, Michael is an sole proprietor health care provider with primary practice located at 2301 S Broad St Rm 112 , Philadelphia PA 19148-3542. He recently has only one registered license in Hospitals / General Acute Care Hospital, which is considered as his primary health care specialty. Riesa, Michael can be contacted via phone (215) 510-2176.Contact Information
Primary practice address
2301 S Broad St Rm 112
Philadelphia PA 19148-3542
Phone: (215) 510-2176
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Hospitals / General Acute Care Hospital | 282N00000X | 25MB09676000 | New Jersey |
| Hospitals / General Acute Care Hospital | 282N00000X | OS020721 | Pennsylvania |
Profile Details
| NPI number | 1932462397 |
|---|---|
| LBN Legal business name | Riesa, Michael |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 20th, 2012 |
| Last updated | Oct 20th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932462397 | NPPES |
| New Jersey | MEDICAID | 0467618 |
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