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Organization

RIVERSIDE PEDIATRIC GROUP PC

Active
Parent organization
RIVERSIDE PEDIATRIC GROUP, PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RIVERSIDE PEDIATRIC GROUP, PC
Authorized official
GAURANG RAVAJI BRAHMBHATT (CMO)
(551) 257-7030
Entity
Organization

Contact information

Practice address
167 AVENUE AT THE CMN, SHREWSBURY, NJ 07702-4805
(732) 389-2555
Mailing address
1 HARMON PLZ FL 10, SECAUCUS, NJ 07094-2803
(201) 636-7233

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
08/25/2022
Last updated
08/25/2022
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