| Riverside Medical Group Pllc | |
|
1010 N Broadway Yonkers NY 10701-1303 | |
| (914) 968-3535 | |
| (914) 968-3566 |
| Full Name | Riverside Medical Group Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1010 N Broadway, Yonkers, New York |
| Authorized Official Name and Position | Sudhakar Reddy Mettu (PRESIDENT) |
| Authorized Official Contact | 9149683535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Medical Group Pllc 1010 N Broadway Yonkers NY 10701-1303 Ph: (914) 968-3535 | Riverside Medical Group Pllc 1010 N Broadway Yonkers NY 10701-1303 Ph: (914) 968-3535 |
| NPI Number | 1265477137 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 04/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265477137 | NPI | - | NPPES |
| 02544136 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 158051 (New York) | Primary |
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