# FIRST RIVERSIDE MEDICAL CARE P.C.

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

## Provider details

- **NPI number:** 1346562949
- **Authorized official:** XIN TAN MD (PRESIDENT)
- **Authorized official phone:** (718) 661-4800

## Contact information

- **Practice address:** 4242 COLDEN ST, SUITE L17, FLUSHING, NY 11355-4855
- **Practice address phone:** (718) 661-4800
- **Practice address fax:** (718) 888-2701
- **Mailing address:** 4242 COLDEN ST, SUITE L17, FLUSHING, NY 11355-4855
- **Mailing address phone:** (718) 661-4800
- **Mailing address fax:** (718) 888-2701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 219846 | NY | Yes |

## Other

- **Enumeration date:** 02/23/2010
- **Last updated:** 02/23/2010