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Individual
BRIAN LARRY RISAVI
Active
Individual
BRIAN LARRY RISAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS009354L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025185301
UNIVERA
NY
05
—
0018025310001
—
PA
01
—
02083085
NY MEDICAID
NY
01
—
1068836
WEST VIRGINIA WORK COMP
WV
01
—
108059
UNISON
PA
01
—
1514333
GATEWAY
PA
01
—
212665
UPMC
PA
01
—
2219727
OH MEDICAID
OH
01
—
2545956
AETNA
PA
01
—
436535
BLUE SHIELD
PA
01
—
930092901
RR MEDICARE
PA
Enumeration date
07/20/2005
Last updated
03/28/2013
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