# RIVERSIDE DIABETES CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215892757
- **Authorized official:** INGEBORG JACKS-CURTIS (MANAGER)
- **Authorized official phone:** (301) 873-3313

## Contact information

- **Practice address:** 6510 KENILWORTH AVE STE 1200, RIVERDALE, MD 20737-1339
- **Practice address phone:** (301) 927-7750
- **Practice address fax:** (240) 582-7411
- **Mailing address:** 6510 KENILWORTH AVE STE 1200, RIVERDALE, MD 20737-1339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2025
- **Last updated:** 12/17/2025