Organization
RIVERSIDE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM BAKER J.D., M.P.P (EXECUTIVE PRACTICE ADMINISTRATOR)
(201) 774-0149
Entity
Organization
Contact information
Practice address
714 10TH ST, SECAUCUS, NJ 07094-2921
(201) 865-2050
Mailing address
714 10TH ST, SECAUCUS, NJ 07094-2921
(201) 865-2050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00655100
NJ
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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