Provider Demographics
NPI:1912949314
Name:RIVER RADIOLOGY PLLC
Entity Type:Organization
Organization Name:RIVER RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-340-4500
Mailing Address - Street 1:PO BOX 2270
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-2270
Mailing Address - Country:US
Mailing Address - Phone:845-339-7582
Mailing Address - Fax:845-338-5616
Practice Address - Street 1:45 PINE GROVE AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-340-4500
Practice Address - Fax:845-340-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0202X
NY261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01896244Medicaid
NYW30681Medicare PIN