Healthcare Provider Details

I. General information

NPI: 1417659459
Provider Name (Legal Business Name): ALGERT RISTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N CHILLICOTHE RD STE 100
AURORA OH
44202-8799
US

IV. Provider business mailing address

55 N CHILLICOTHE RD STE 100
AURORA OH
44202-8799
US

V. Phone/Fax

Practice location:
  • Phone: 330-954-7210
  • Fax: 330-954-7211
Mailing address:
  • Phone: 330-954-7210
  • Fax: 330-954-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: