# RIVERSIDE PHYSICIAN SERVICES INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE HEALTHCARE ASSOCIATES INC
- **Other names:** Riverside Mathews Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295756096
- **Legal business name:** RIVERSIDE HEALTHCARE ASSOCIATES INC
- **Authorized official:** JAMES LESNICK MD (VICE PRESIDENT)
- **Authorized official phone:** (757) 594-4006

## Contact information

- **Practice address:** 10976 BUCKLEY HALL ROAD, MATHEWS, VA 23109
- **Practice address phone:** (804) 725-5005
- **Practice address fax:** (757) 725-3204
- **Mailing address:** 856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 594-4006
- **Mailing address fax:** (754) 534-5190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | VA | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 10/15/2014