Provider Demographics
NPI:1528212446
Name:RIVERSIDE FRIENDLY NEUROLOGY INC
Entity Type:Organization
Organization Name:RIVERSIDE FRIENDLY NEUROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVCIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-339-1499
Mailing Address - Street 1:350 INTERLOCKEN BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3477
Mailing Address - Country:US
Mailing Address - Phone:303-339-1499
Mailing Address - Fax:303-339-1498
Practice Address - Street 1:350 INTERLOCKEN BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3477
Practice Address - Country:US
Practice Address - Phone:303-339-1499
Practice Address - Fax:303-339-1498
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRONERVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty