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Organization
RIVERDALE FAMILY MEDICAL PRACTICE
Active
Organization
RIVERDALE FAMILY MEDICAL PRACTICE
Active
Other names
RIVERDALE FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK J MASELLI M.D. (MEDICAL DIRECTOR)
(718) 543-2700
Entity
Organization
Contact information
Practice address
3050 CORLEAR AVE, SUITE 201, BRONX, NY 10463-3815
(718) 543-2700
(718) 601-0965
Mailing address
3050 CORLEAR AVE, SUITE 201, BRONX, NY 10463-5180
(718) 543-2700
(718) 601-0965
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WWQ371
MEDICARE/GROUP#
NY
Enumeration date
01/17/2007
Last updated
07/09/2015
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