Healthcare Provider Details

I. General information

NPI: 1508929456
Provider Name (Legal Business Name): RIVER ROAD PEDIATRICS, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 HAWTHORNE DR
BEDFORD NH
03110-6912
US

IV. Provider business mailing address

58 HAWTHORNE DR
BEDFORD NH
03110-6912
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-8619
  • Fax: 603-625-0866
Mailing address:
  • Phone: 603-622-8619
  • Fax: 603-625-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARTIN E SCHWARTZBERG
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 603-622-8619