Provider Demographics
NPI:1619937299
Name:RAIZMAN, EMMA (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:
Last Name:RAIZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-764-3457
Mailing Address - Fax:330-764-3464
Practice Address - Street 1:3443 MEDINA RD STE 115
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5965
Practice Address - Country:US
Practice Address - Phone:330-764-3457
Practice Address - Fax:330-764-3464
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.077227208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D0256Medicare ID - Type Unspecified
H90483Medicare UPIN
TX170220101Medicaid