Organization
RIVERSIDE FAMILY PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM JARRETT M.D. (CMO, M.D.)
(201) 833-3000
Entity
Organization
Contact information
Practice address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 833-3909
(201) 833-7073
Mailing address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 833-3000
(201) 227-6207
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA05312800
NJ
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25MA06291500
NJ
207R00000X
Internal Medicine Physician
25MA03273300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203130405
TAX IDENTIFICATION #
NJ
Enumeration date
07/15/2006
Last updated
05/01/2013
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