MEDICARE: MS. RIYE AOKI D.O.

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	207Q00000X	Family Medicine Physician	042785	CT

General Provider Information

NPI Number	:	1023211216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RIYE AOKI D.O.

Provider Business Mailing Address
First Line	:	112 PORTLAND AVE
Second Line	:
City	:	WEST REDDING
State	:	CT
Zip	:	06896-3119
Country	:	US
Telephone Number	:	203-544-9090
Fax Number	:	203-544-7300

Provider Business Practice Location Address
First Line	:	112 PORTLAND AVE
Second Line	:
City	:	WEST REDDING
State	:	CT
Zip	:	06896-3119
Country	:	US
Telephone Number	:	203-544-9090
Fax Number	:	203-544-7300

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

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	07/08/2007

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