Organization
OPTUM MEDICAL CARE OF NEW JERSEY PC
Active
Parent organization
OPTUM MEDICAL CARE OF NEW JERSEY PC
Other names
Riverside Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
OPTUM MEDICAL CARE OF NEW JERSEY PC
Authorized official
GAURANG RAVAJI BRAHMBHATT MD (CREDENTIALING SUPERVISOR)
(201) 706-8490
Entity
Organization
Contact information
Practice address
264 BOYDEN AVE, MAPLEWOOD, NJ 07040-3070
(973) 761-5200
(973) 761-7617
Mailing address
1 HARMON PLZ FL 10, SECAUCUS, NJ 07094-2803
(551) 220-4832
(551) 257-7255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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