Provider Demographics
NPI:1942237425
Name:RIOLO, STEPHANIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:RIOLO
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 1:1001 E 2ND ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1372
Mailing Address - Country:US
Mailing Address - Phone:937-607-1710
Mailing Address - Fax:
Practice Address - Street 1:1001 E 2ND ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1372
Practice Address - Country:US
Practice Address - Phone:937-607-1710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350877792084P0804X
MI43010774852084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2356927Medicaid
OH2356927Medicaid
H45681Medicare UPIN