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General NPI Number Information
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NPI Number | 1053051565
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Entity Type | Organization
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Legal Business Name | RIVERSIDE MEDICATION MANAGEMENT LLC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 670 RIVERSIDE DR
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City | NEW YORK
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State | NY
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Zip | 10031-5520
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Country | US
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Telephone | 917-969-0299
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Fax |
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Provider Business Mailing Address
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Address Line | 670 RIVERSIDE DR
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City | NEW YORK
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State | NY
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Zip | 10031-5520
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Country | US
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Telephone | 619-952-2232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MONIQUE WELBECK
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Credential | DNP
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Telephone | 619-952-2232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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