MEDICARE: BRIAN JAMES RIEGEL MD

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	207RC0000X	Cardiovascular Disease Physician	218502	NY
2	207UN0901X	Nuclear Cardiology Physician	218502	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RB6956	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000527333001	OTHER	NY	BLUE CROSS COMMUNITY BLUE
3	00026413301	OTHER	NY	UNIVERAL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2111669	OTHER	NY	INDEP HEALTH
6	00026413303	OTHER		UNIVERA

General Provider Information

NPI Number	:	1992788657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN JAMES RIEGEL MD

Provider Business Mailing Address
First Line	:	908 NIAGARA FALLS BLVD STE 208
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-2019
Country	:	US
Telephone Number	:	716-692-3302
Fax Number	:	716-692-4342

Provider Business Practice Location Address
First Line	:	705 MAPLE RD STE 300
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-3291
Country	:	US
Telephone Number	:	716-710-8266
Fax Number	:	716-710-8266

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

Provider Enumeration Date	:	11/26/2005
Last Update Date	:	11/08/2017

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