Organization
RIVERSIDE DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY ROBBINS M.D. (OWNER)
(610) 261-1115
Entity
Organization
Contact information
Practice address
5649 WYNNEWOOD DR, SUITE 202, LAURYS STATION, PA 18059-1138
(610) 261-1115
(610) 261-9601
Mailing address
5649 WYNNEWOOD DR, SUITE 202, LAURYS STATION, PA 18059-1138
(610) 261-1115
(610) 261-9601
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02352200
CAPITAL BLUE CROSS
PA
01
—
1611176
HIGHMARK BLUE SHIELD
PA
01
—
2288874000
PERSONAL CHOICE
—
01
—
501504
AETNA
—
01
—
P00089866
RAILROAD MEDICARE
—
Enumeration date
05/02/2006
Last updated
08/22/2020
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