Organization
RIVERSIDE HOSPITAL INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATES
Other names
Riverside Brentwood Medical Center - Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOCIATES
Authorized official
JAMES LESNICK (VICE PRESIDENT)
(757) 594-4006
Entity
Organization
Contact information
Practice address
10510 JEFFERSON AVE, SUITES A, NEWPORT NEWS, VA 23601-3102
(757) 594-3800
(757) 594-3818
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
(757) 594-4006
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG6038
MEDICARE RAILROAD
VA
Enumeration date
07/14/2006
Last updated
10/15/2014
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