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RIVERSIDE PREVENTATIVE HEALTH LLC NPI 1750895900


NPI Information

NPI: 1750895900
Provider Name: RIVERSIDE PREVENTATIVE HEALTH LLC
Classification: Internal Medicine - 207RS0010X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 31D2035209

Address:
1 JOURNAL SQUARE PLZ STE 303
JERSEY CITY, NJ
ZIP 07306
Phone: (914) 376-6100
Get Directions

RIVERSIDE PREVENTATIVE HEALTH LLC is a sports medicine internal medicine in Jersey City, NJ. The provider is an internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual. RIVERSIDE PREVENTATIVE HEALTH LLC NPI is 1750895900. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 JOURNAL SQUARE PLZ STE 303
JERSEY CITY, NJ
ZIP 07306-004
Phone: (914) 376-6100
Fax: (914) 231-6872

The provider's authorized official is Melissa Nieli .
The authorized official title is Credentialing Manager and has the following contact phone number (914) 376-6100.

The CLIA number assigned to this NPI record is 31D2035209 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/27/2017 and was last updated on 11/27/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RS0010XInternal MedicineSports MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERNEW JERSEYTAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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