Provider Demographics
NPI:1740284736
Name:AKSTEIN, RICARDO BRASILIANO (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:BRASILIANO
Last Name:AKSTEIN
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:86 UPPER RIVERDALE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274
Mailing Address - Country:US
Mailing Address - Phone:770-996-4844
Mailing Address - Fax:770-907-0884
Practice Address - Street 1:86 UPPER RIVERDALE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274
Practice Address - Country:US
Practice Address - Phone:770-996-4844
Practice Address - Fax:770-907-0884
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA018778207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP925OtherMEDICARE GROUP NUMBER
GAD28768Medicare UPIN