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NPI Code Detail

MEDICARE: JEFFREY P RISKIN LISW

MEDICARE: JEFFREY P RISKIN LISW
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
1104100000XSocial Worker1-0005349OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1537593000OTHEROHMAGELLAN
2716073000OTHEROHMAGELLAN GROUP
398171OTHEROHQUAL CHOICE

General Provider Information

NPI Number : 1073599379
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY P RISKIN LISW
Provider Business Mailing Address
First Line : PO BOX 638269
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-0001
Country : US
Telephone Number : 440-816-5790
Fax Number :
Provider Business Practice Location Address
First Line : 7265 OLD OAK BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-3342
Country : US
Telephone Number : 440-816-5790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 03/16/2026

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Directions to “ JEFFREY P RISKIN LISW” Practice Location

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