Organization
RIVERSIDE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G DAVID SMITH PHD (PRESIDENT PSYCHOLOGIST)
(717) 238-6880
Entity
Organization
Contact information
Practice address
2818 GREEN ST, HARRISBURG, PA 17110-1228
(717) 238-6880
(717) 238-6885
Mailing address
2818 GREEN ST, HARRISBURG, PA 17110-1228
(717) 238-6880
(717) 238-6885
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02433600
CAPITAL BLUE CROSS
PA
05
—
1000022870005
—
PA
01
—
641061
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/19/2006
Last updated
08/09/2007
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