Provider Demographics
NPI:1720165848
Name:REIKOWSKI, RICHARD S (AUD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:REIKOWSKI
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 WALTER CT
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1648
Mailing Address - Country:US
Mailing Address - Phone:330-633-0140
Mailing Address - Fax:
Practice Address - Street 1:2800 S ARLINGTON RD
Practice Address - Street 2:STE 102
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4702
Practice Address - Country:US
Practice Address - Phone:330-644-1932
Practice Address - Fax:330-475-0780
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01056231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311534810RSOtherSUMMA - FHC
OH000000121488OtherANTHEM
OHRE4119851Medicare ID - Type UnspecifiedCUHC
OH311534810RSOtherSUMMA - FHC