RIVERSIDE SURGERY & BREASTCARE (NPI# 1104873975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104873975 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE SURGERY & BREASTCARE |
| Practice Address |
355 Riverside Dr Johnson City NY 13790-2708 |
| Practice Telephone | 6077980706 |
| Mailing Telephone | 6077980706 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DARIUSH VAZIRI (PHYSICIAN) |
| Authorized Official Telephone | 6077980706 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
355 RIVERSIDE DR |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134119209 | Ghassem Mangouri | Surgery | 355 Riverside Dr, Johnson City, NY 13790-2708 | 2005-10-28 |
| 1144659533 | Andrea Lynn Cranage | Registered Nurse | 355 Riverside Dr, Johnson City, NY 13790-2744 | 2013-11-06 |
| 1295725364 | Dariush Vaziri | Surgery | 355 Riverside Dr, Johnson City, NY 13790-2708 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1235469974 | Jeffrey Scott Wiseman | Surgery | 30 Harrison St Ste 455, Johnson City, NY 13790-2176 | 2009-12-31 |
| 1750301685 | Surgical Group of Johnson City, Mpc | Surgery | 310 N State of Franklin Rd Ste 404, Johnson City, TN 37604-6063 | 2006-07-21 |
| 1184660482 | Daniel Brooks Drinnen | Surgery | 300 E Main St Ste 301, Johnson City, TN 37601-5708 | 2006-06-22 |
| 1508821067 | James Bracken Burns Jr. | Surgery | Dogwood Ave, Bldg #1, Room 2-42, Johnson City, TN 37614 | 2006-04-19 |
| 1801851324 | Annamalai Periakaruppan | Surgery | 180 Harry L Dr, Johnson City, NY 13790-1566 | 2006-04-18 |
| 1588641187 | Michael J Hodge | Surgery | 2333 Knob Creek Rd Ste 16, Johnson City, TN 37604-2007 | 2005-12-27 |
| 1134119209 | Ghassem Mangouri | Surgery | 355 Riverside Dr, Johnson City, NY 13790-2708 | 2005-10-28 |
| 1437145687 | Paul Thurdekoos | Surgery | 3 Professional Park Dr, Suite 31, Johnson City, TN 37604-6529 | 2005-09-23 |
| 1700872959 | Kenneth E. Cutshall | Surgery | 3 Professional Park Dr Ste 31, Johnson City, TN 37604-6529 | 2005-09-23 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.