Provider Demographics
NPI:1801629076
Name:RIVERSIDE HEALTHCARE ASSOCIATION INC
Entity type:Organization
Organization Name:RIVERSIDE HEALTHCARE ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED DIABETES CARE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:YUHAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN/CDCES
Authorized Official - Phone:757-636-3456
Mailing Address - Street 1:500 J CLYDE MORRIS BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1929
Mailing Address - Country:US
Mailing Address - Phone:757-636-3456
Mailing Address - Fax:
Practice Address - Street 1:500 J CLYDE MORRIS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1929
Practice Address - Country:US
Practice Address - Phone:757-636-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVMS/MACON AND BROCK HEALTH SCIENCES AT OLD DOMINION UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty