Provider Demographics
NPI:1861632317
Name:RIVERDALE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:RIVERDALE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:IODICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-200-5076
Mailing Address - Street 1:44 STATE RT 23
Mailing Address - Street 2:STE 15A
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457-1603
Mailing Address - Country:US
Mailing Address - Phone:973-200-5076
Mailing Address - Fax:973-200-5451
Practice Address - Street 1:44 STATE RT 23
Practice Address - Street 2:STE 15A
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1603
Practice Address - Country:US
Practice Address - Phone:973-200-5076
Practice Address - Fax:973-200-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical