# RIVERSIDE FAMILY PRACTICE, PC

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

## Provider details

- **NPI number:** 1730106196
- **Authorized official:** ADAM JARRETT M.D. (CMO, M.D.)
- **Authorized official phone:** (201) 833-3000

## Contact information

- **Practice address:** 718 TEANECK RD, TEANECK, NJ 07666-4245
- **Practice address phone:** (201) 833-3909
- **Practice address fax:** (201) 833-7073
- **Mailing address:** 718 TEANECK RD, TEANECK, NJ 07666-4245
- **Mailing address phone:** (201) 833-3000
- **Mailing address fax:** (201) 227-6207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 25MA05312800 | NJ | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 25MA06291500 | NJ | Yes |
| 207R00000X | Internal Medicine Physician | 25MA03273300 | NJ | — |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 05/01/2013