Healthcare Provider Details
I. General information
NPI: 1912949314
Provider Name (Legal Business Name): RIVER RADIOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 PINE GROVE AVE
KINGSTON NY
12401
US
IV. Provider business mailing address
PO BOX 2270
KINGSTON NY
12402-2270
US
V. Phone/Fax
- Phone: 845-340-4500
- Fax: 845-340-4501
- Phone: 845-339-7582
- Fax: 845-338-5616
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
STEVEN
D
SCHWARTZ
Title or Position: RADIOLOGIST/CEO
Credential: MD
Phone: 845-340-4500