MEDICARE: MAUREEN CASSIDY RISKI AU.D.

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	231H00000X	Audiologist	AUD003173	GA

General Provider Information

NPI Number	:	1265606891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN CASSIDY RISKI AU.D.

Provider Business Mailing Address
First Line	:	3495 PIEDMONT ROAD, NE
Second Line	:	NINE PIEDMONT CENTER
City	:	ATLANTA
State	:	GA
Zip	:	30305
Country	:	US
Telephone Number	:	404-364-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 OLD MILTON PKWY STE 520
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4626
Country	:	US
Telephone Number	:	770-777-1100
Fax Number	:	770-751-9089

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

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	09/04/2019

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