RIVERSIDE MEDICAL GROUP PLLC (NPI# 1265477137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265477137 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE MEDICAL GROUP PLLC |
| Practice Address |
1010 N Broadway Yonkers NY 10701-1303 |
| Practice Telephone | 9149683535 |
| Practice Fax Number | 9149683566 |
| Mailing Telephone | 9149683535 |
| Mailing Fax Number | 9149683566 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2008-04-16 |
| Authorized Official Name | DR. SUDHAKAR REDDY METTU (PRESIDENT) |
| Authorized Official Telephone | 9149683535 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
158051 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02544136 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538379664 | Riverside Medical Group Pllc | Internal Medicine | 401 6th Ave, Suite 102, Montgomery, WV 25136-2116 | 2007-05-24 |
| Street Address |
1010 N BROADWAY |
| City | YONKERS |
| State | NY |
| Zip Code | 10701-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750693842 | Paul Ginelli | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1330 | 2010-07-06 |
| 1023334927 | Mount Sinai School of Medicine of New York University | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1303 | 2010-04-16 |
| 1215269238 | Sara Michiko Tanaka Carroll | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1330 | 2010-02-01 |
| 1740442656 | Zeenat Naqvi | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1330 | 2008-07-01 |
| 1669642252 | Steven Albert Francescone | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1330 | 2008-03-10 |
| 1023202918 | Atul M Limaye | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1303 | 2007-09-04 |
| 1740480268 | Judith Zwer | Clinical Nurse Specialist | 1010 N Broadway, Yonkers, NY 10701-1303 | 2007-07-23 |
| 1790904548 | Alon Gitig | Internal Medicine | 1010 N Broadway, Yonkers, NY 10701-1330 | 2007-04-24 |
| 1609927995 | Glory Mathew | Nurse Practitioner | 1010 N Broadway, Yonkers, NY 10701-1330 | 2007-01-15 |
| 1760559272 | Minal Patel | Medical Genetics, Ph.D. Medical Genetics | 1010 N Broadway, Yonkers, NY 10701-1303 | 2006-11-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356978357 | Nisha Ann Jacob | Student in an Organized Health Care Education/Training Program | Saint Joseph's Medical Center, 127 South Broadway, Yonkers, NY 10701 | 2020-03-27 |
| 1306471412 | Mchealth Nemt LLC | Non-emergency Medical Transport (VAN) | 10 Locust Hill Avenue, Suite 2, Yonkers, NY 10701 | 2020-03-09 |
| 1073150314 | Daniel Owusu-ansah | Registered Nurse | 615 Warburton Ave, Apt 4e, Yonkers, NY 10701 | 2019-12-05 |
| 1447738067 | Britney Hudson | Counselor | 58 Hudson St, Yonkers, NY 10701 | 2018-08-06 |
| 1104320704 | Jonathan Alfred Manley | Specialist | 1 Odell Plaza - Fred S. Keller School, Suite #263, Yonkers, NY 10701 | 2018-03-20 |
| 1841718905 | Tanesha Lyttle | Licensed Practical Nurse | 50 Hewphorne Ave., Yonkers, NY 10701 | 2017-09-08 |
| 1598297715 | Lauren Ramm | Surgery | 967 North Broadway, Medical Education Department, Yonkers, NY 10701 | 2017-03-28 |
| 1063953115 | Gina Bianca Butrico | Early Intervention Provider Agency | 300 Corporate Blvd. South, Yonkers, NY 10701 | 2017-03-09 |
| 1225574551 | Syed Islam | Assistant Behavior Analyst | 6 B Greene Pl., Yonkers, NY 10701 | 2017-01-10 |
| 1306296470 | Rebecca Hill | Physician Assistant | 984 N Broadway Ste 509, Yonkers, NY 10701 | 2016-06-20 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1497944284 | Yonkers Family Practice, PC | Clinic/Center | 45 Ludlow St, Suite 700, Yonkers, NY 10705-1947 | 2007-10-17 |
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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.