MEDICARE: SAMIN RIYAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.008780RX	OH

General Provider Information

NPI Number	:	1861182123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIN RIYAZ

Provider Business Mailing Address
First Line	:	2123 AUBURN AVE STE 723
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:	513-585-3275
Fax Number	:	513-978-5806

Provider Business Practice Location Address
First Line	:	2123 AUBURN AVE STE 723
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:	513-585-3275
Fax Number	:	513-978-5806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	01/11/2026

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Directions to “ SAMIN RIYAZ ” Practice Location

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