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General NPI Number Information
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NPI Number | 1245291483
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Entity Type | Organization
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Legal Business Name | RIVERVIEW UROLOGIC ASSOCIATES
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 423 3RD AVE SUITE B
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City | KINGSTON
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State | PA
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Zip | 18704-5809
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Country | US
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Telephone | 570-288-3601
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Fax | 570-288-1726
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Provider Business Mailing Address
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Address Line | 423 3RD AVE SUITE B
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City | KINGSTON
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State | PA
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Zip | 18704-5809
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Country | US
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Telephone | 570-288-3601
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Fax | 570-288-1726
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL HARRIS RITTENBERG
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Credential | M.D.
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Telephone | 570-288-3601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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