Organization
RIVERSIDE PHARMACY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAN VODOOR (PRESIDENT)
(212) 491-5500
Entity
Organization
Contact information
Practice address
2920 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10039-1610
(212) 491-5500
(212) 491-5501
Mailing address
2920 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10039-1610
(212) 491-5500
(212) 491-5501
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
026816
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02595733
—
NY
Enumeration date
02/09/2007
Last updated
08/22/2020
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