MEDICARE: BECKETT RIDGE FAMILY MEDICINE, INC.

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	34008204	OH
2	207Q00000X	Family Medicine Physician	35060538	OH

General Provider Information

NPI Number	:	1740337765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BECKETT RIDGE FAMILY MEDICINE, INC.

Provider Business Mailing Address
First Line	:	4870 WUNNENBERG WAY
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-4863
Country	:	US
Telephone Number	:	513-860-4600
Fax Number	:	513-860-9059

Provider Business Practice Location Address
First Line	:	4870 WUNNENBERG WAY
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-4863
Country	:	US
Telephone Number	:	513-860-4600
Fax Number	:	513-860-9059

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER J DIATTE
Credential	:	M.D.
Telephone Number	:	513-860-4600

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	01/08/2026

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