Provider Demographics
NPI:1831401850
Name:RIVER VIEW PEDIATRICS, PC
Entity type:Organization
Organization Name:RIVER VIEW PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FINOCCHIARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-598-6785
Mailing Address - Street 1:909 W 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-5050
Mailing Address - Country:US
Mailing Address - Phone:315-529-4987
Mailing Address - Fax:315-592-3571
Practice Address - Street 1:909 W 1ST ST S
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-5050
Practice Address - Country:US
Practice Address - Phone:315-529-4987
Practice Address - Fax:315-592-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2751322080A0000X
NY2777922080A0000X
NY2839952080A0000X
NY2495302080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04153068Medicaid
NY04427125Medicaid
NY03236775Medicaid
NY03921675Medicaid