Healthcare Provider Details
I. General information
NPI: 1336617331
Provider Name (Legal Business Name): RIVERTOWNS PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2018
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18 ASHFORD AVE STE 3W
DOBBS FERRY NY
10522-1824
US
IV. Provider business mailing address
18 ASHFORD AVE STE 3W
DOBBS FERRY NY
10522-1824
US
V. Phone/Fax
- Phone: 914-330-8445
- Fax:
- Phone: 914-330-8445
- Fax: 914-330-8446
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
NITIN
GUPTA
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 914-330-8445