Healthcare Provider Details

I. General information

NPI: 1801091533
Provider Name (Legal Business Name): RIVERDALE MEDICINE,LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3736 HENRY HUDSON PKWY
BRONX NY
10463-1502
US

IV. Provider business mailing address

3736 HENRY HUDSON PKWY
BRONX NY
10463-1502
US

V. Phone/Fax

Practice location:
  • Phone: 718-796-0100
  • Fax: 718-549-7178
Mailing address:
  • Phone: 718-796-0100
  • Fax: 718-549-7178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KALMAN AUSUBEL
Title or Position: PARTNER
Credential: MD
Phone: 718-796-0100