# RIVERSIDE PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE PHYSICIAN SERVICES INC
- **Other names:** CEAGH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578804704
- **Legal business name:** RIVERSIDE PHYSICIAN SERVICES INC
- **Authorized official:** JAMES E LESNICK MD (VICE PRESIDENT)
- **Authorized official phone:** (757) 594-4006

## Contact information

- **Practice address:** 3901 TREYBURN DR, SUITE 100, WILLIAMSBURG, VA 23185-2891
- **Practice address phone:** (757) 220-4751
- **Mailing address:** 856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 594-4006
- **Mailing address fax:** (757) 534-5190

## Taxonomy

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

## Other

- **Enumeration date:** 03/13/2013
- **Last updated:** 03/13/2013