# RIVER MEDICAL PRACTICE PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVER HOSPITAL, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407785587
- **Legal business name:** RIVER HOSPITAL, INC.
- **Authorized official:** KELLEY TIERNAN (CEO)
- **Authorized official phone:** (315) 482-2511

## Contact information

- **Practice address:** 300 CHAPMAN STREET RD, MORRISTOWN, NY 13664-3254
- **Practice address phone:** (315) 482-2511
- **Practice address fax:** (315) 482-7506
- **Mailing address:** 4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
- **Mailing address phone:** (315) 482-2511
- **Mailing address fax:** (315) 482-7506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/15/2026
- **Last updated:** 09/28/2026