Provider Demographics
NPI:1073760351
Name:CHILDREN'S HEALTHCARE OF ATLANTA
Entity Type:Organization
Organization Name:CHILDREN'S HEALTHCARE OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SPEECH PATHOLOGY LABORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RISKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-401-1840
Mailing Address - Street 1:8325 HEWLETT RD
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3506
Mailing Address - Country:US
Mailing Address - Phone:404-401-1840
Mailing Address - Fax:404-785-3706
Practice Address - Street 1:8325 HEWLETT RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-3506
Practice Address - Country:US
Practice Address - Phone:404-401-1840
Practice Address - Fax:404-785-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003109282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren