Provider Demographics
NPI:1821215179
Name:DOCTORS AT RIVERSIDE
Entity Type:Organization
Organization Name:DOCTORS AT RIVERSIDE
Other - Org Name:RIVERSIDE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REIDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-850-5055
Mailing Address - Street 1:9 RIVERSIDE PLZ
Mailing Address - Street 2:ROUTE 57
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4100
Mailing Address - Country:US
Mailing Address - Phone:908-850-5055
Mailing Address - Fax:908-850-0429
Practice Address - Street 1:9 RIVERSIDE PLZ
Practice Address - Street 2:ROUTE 57
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4100
Practice Address - Country:US
Practice Address - Phone:908-850-5055
Practice Address - Fax:908-850-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Not Answered261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Not Answered261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD07640Medicare UPIN
NJ002868QGTMedicare ID - Type UnspecifiedDR. MEYER-GRIMES
NJ483002QGTMedicare ID - Type UnspecifiedDR. ROLANDO ROBLEZA
NJC75542Medicare UPIN