RIVERSIDE MEDICAL GROUP PLLC NPI 1265477137

NPI Information

NPI: 1265477137
Provider Name: RIVERSIDE MEDICAL GROUP PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1010 N BROADWAY
YONKERS, NY
ZIP 10701
Phone: (914) 968-3535
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RIVERSIDE MEDICAL GROUP PLLC is a primary care clinic center in Yonkers, NY. RIVERSIDE MEDICAL GROUP PLLC NPI is 1265477137. The provider is registered as an organization entity type.

The provider's business location address is:

1010 N BROADWAY
YONKERS, NY
ZIP 10701-303
Phone: (914) 968-3535
Fax: (914) 968-3566

The provider's authorized official is Sudhakar Reddy Mettu .
The authorized official title is President and has the following contact phone number (914) 968-3535.

The enumeration date for this NPI number is 6/17/2006 and was last updated on 4/16/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	158051	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02544136	MEDICAID	NEW YORK
2	WEL651	MEDICARE PIN	NEW YORK

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: 4/28/2024

NPI Synchronization or Removal

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