Provider Demographics
NPI:1689822942
Name:RIVERFRONT NEUROLOGY LLC
Entity Type:Organization
Organization Name:RIVERFRONT NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-387-8811
Mailing Address - Street 1:755 MEMORIAL PKWY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2748
Mailing Address - Country:US
Mailing Address - Phone:908-387-8811
Mailing Address - Fax:908-387-6772
Practice Address - Street 1:755 MEMORIAL PKWY
Practice Address - Street 2:SUITE 114
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2748
Practice Address - Country:US
Practice Address - Phone:908-387-8811
Practice Address - Fax:908-387-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0172553Medicaid
NJ0172553Medicaid
PA079536Medicare PIN
NJ140538Medicare PIN