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OPTUM MEDICAL CARE OF NEW JERSEY PC NPI 1487193454


NPI Information

NPI: 1487193454
Provider Name: OPTUM MEDICAL CARE OF NEW JERSEY PC

Doing Business As: RIVERSIDE MEDICAL GROUP

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 31D0999926

Address:
625 MAIN AVE
SECOND FL
PASSAIC, NJ
ZIP 07055
Phone: (973) 614-9800
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OPTUM MEDICAL CARE OF NEW JERSEY PC is a durable medical equipment medical supplies in Passaic, NJ. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. OPTUM MEDICAL CARE OF NEW JERSEY PC NPI is 1487193454. The provider is registered as an organization entity type.
The provider Is Doing Business As Riverside Medical Group.

The provider's business location address is:

625 MAIN AVE
SECOND FL
PASSAIC, NJ
ZIP 07055-952
Phone: (973) 614-9800
Fax: (973) 614-0151

The provider's authorized official is Gaurang Ravaji Brahmbhatt .
The authorized official title is Cmo and has the following contact phone number (201) 636-7233.

The CLIA number assigned to this NPI record is 31D0999926 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2017 and was last updated on 6/2/2023.


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
1332B00000XDurable Medical Equipment & Medical SuppliesYes

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: 5/5/2024

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