Healthcare Provider Details

I. General information

NPI: 1508821646
Provider Name (Legal Business Name): RIVERSIDE MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 VARNUM AVE STE 201
LOWELL MA
01854-2141
US

IV. Provider business mailing address

275 VARNUM AVE STE 201
LOWELL MA
01854-2141
US

V. Phone/Fax

Practice location:
  • Phone: 978-452-9700
  • Fax: 978-441-6075
Mailing address:
  • Phone: 978-452-9700
  • Fax: 978-441-6075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LINCOLN N PINSKY
Title or Position: PRESIDENT
Credential: MD
Phone: 978-452-9700