Provider Demographics
NPI:1659463180
Name:RIACHI, P.C.
Entity Type:Organization
Organization Name:RIACHI, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LABIB
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIACHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-723-1234
Mailing Address - Street 1:320 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1826
Mailing Address - Country:US
Mailing Address - Phone:908-723-1234
Mailing Address - Fax:908-928-0262
Practice Address - Street 1:128 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2130
Practice Address - Country:US
Practice Address - Phone:908-928-1234
Practice Address - Fax:908-928-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07007000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ103331Medicare PIN