Organization
RIVERSIDE INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NEIL N BOSIDE M.D. (PRESIDENT)
(203) 637-0057
Entity
Organization
Contact information
Practice address
1200 E PUTNAM AVE, RIVERSIDE, CT 06878-1430
(203) 637-0057
(203) 637-3280
Mailing address
1200 E PUTNAM AVE, RIVERSIDE, CT 06878-1430
(203) 637-0057
(203) 637-3280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
035452
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010035452CT01
ANTHEM BLUE CROSS
—
01
—
78467
EMPIRE BLUE CROSS
NY
01
—
OV9649
HEALTH NET
CT
01
—
P479423
OXFORD
CT
Enumeration date
12/27/2007
Last updated
01/02/2008
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