Organization
OPTUM MEDICAL CARE OF NEW JERSEY PC
Active
Other names
Riverside Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
GAURANG RAVAJI BRAHMBHATT MD (CMO)
(201) 636-7233
Entity
Organization
Contact information
Practice address
625 MAIN AVE, SECOND FL, PASSAIC, NJ 07055-4952
(973) 614-9800
(973) 614-0151
Mailing address
1 HARMON PLZ FL 10, SECAUCUS, NJ 07094-2803
(201) 636-7233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/23/2017
Last updated
06/02/2023
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