Organization
OPTUM MEDICAL CARE OF NEW JERSEY PC
Active
Organization
OPTUM MEDICAL CARE OF NEW JERSEY PC
Active
Other names
Riverside pediatric group
Organization subpart
No
Provider details
NPI number
Authorized official
GAURANG BRAHMBHATT MD (VP GENERAL MANAGEMENT)
(201) 706-8490
Entity
Organization
Contact information
Practice address
1 DAKOTA DR, NEW HYDE PARK, NY 11042-1135
(516) 627-1811
(516) 627-1315
Mailing address
1 DAKOTA DR, NEW HYDE PARK, NY 11042-1135
(516) 627-1811
(516) 627-1315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08407900
NJ
208000000X
Pediatrics Physician
Primary
25MA03363500
NJ
332B00000X
Durable Medical Equipment & Medical Supplies
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9088008
—
NJ
Enumeration date
09/03/2006
Last updated
08/11/2026
Update your record
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