Basic Information
| Provider Information | |||||||||
| NPI: | 1811970296 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RISCH | ||||||||
| FirstName: | VICTOR | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020A E BOAL AVE | ||||||||
| Address2: | |||||||||
| City: | BOALSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168271509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142378627 | ||||||||
| FaxNumber: | 8142380083 | ||||||||
| Practice Location | |||||||||
| Address1: | CEDAR CREST I78 | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 18105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104020700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2005 | ||||||||
| LastUpdateDate: | 08/23/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD025945E | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 01222901 | 01 | PA | CAPITAL BC | OTHER | 016914 | 01 | PA | BCBS PA | OTHER | P2821009 | 01 | PA | OXFORD | OTHER | 300018185 | 01 | PA | RAILROAD MEDICARE | OTHER | 34109 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 20010565 | 01 | PA | AMERIHEALTH MERCY | OTHER | 0011264370007 | 05 | PA | MEDICAID | 0016914 | 01 | PA | KEYSTONE HEALTHPLAN CENTR | OTHER | 0071398000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 133200 | 01 | PA | MEDPLUS/THREE RIVERS | OTHER | 6123250002 | 01 | PA | CIGNA HMO | OTHER |