Provider Demographics
NPI:1205953304
Name:RIESZ, RONALD ARTHUR (RDO)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ARTHUR
Last Name:RIESZ
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-5106
Mailing Address - Country:US
Mailing Address - Phone:781-643-7325
Mailing Address - Fax:781-643-1326
Practice Address - Street 1:452 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-5106
Practice Address - Country:US
Practice Address - Phone:781-643-7325
Practice Address - Fax:781-643-1326
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1304156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician