Organization
RIVERSIDE MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO MIGLIETTA D.O. (PRESIDENT)
(201) 461-1843
Entity
Organization
Contact information
Practice address
725 RIVER RD, SUITE 106, EDGEWATER, NJ 07020-1171
(201) 943-2273
Mailing address
100 WINSTON DR, 15C-SOUTH, CLIFFSIDE PARK, NJ 07010-3240
(201) 969-8693
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MB06920900
NJ
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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