Provider Demographics
NPI:1407348444
Name:RIVERSKY, INC
Entity Type:Organization
Organization Name:RIVERSKY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:UDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ED
Authorized Official - Phone:171-849-0443
Mailing Address - Street 1:2775 E 12TH ST APT 706
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4638
Mailing Address - Country:US
Mailing Address - Phone:718-490-4434
Mailing Address - Fax:718-615-0881
Practice Address - Street 1:2775 E 12TH ST APT 706
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4638
Practice Address - Country:US
Practice Address - Phone:718-490-4434
Practice Address - Fax:718-615-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty