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Organization
RIVER VALLEY FAMILY MEDICAL SERVICES P.C.
Active
Organization
RIVER VALLEY FAMILY MEDICAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JOHN DABOUL JR. M.D. (PRESIDENT)
(845) 557-6411
Entity
Organization
Contact information
Practice address
3452 STATE ROUTE 97, BARRYVILLE, NY 12719-5923
(845) 557-6411
(845) 557-8005
Mailing address
3452 STATE ROUTE 97, BARRYVILLE, NY 12719-5923
(845) 557-6411
(845) 557-8005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
165904
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN7705
RAILROAD MEDICARE
NY
Enumeration date
01/17/2007
Last updated
05/15/2013
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