| NPI | 1578665048 |
|---|---|
| Former Legal Business Name | RIVERSIDE PEDIATRIC GROUP |
| Entity Type | Organization |
| Authorized Contact | GAURANG BRAHMBHATT Cmo 201-636-7233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA03363500) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 207R00000X Internal Medicine (Licence: NJ 25MA08407900) | |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2022-09-14 |