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General NPI Number Information
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NPI Number | 1356019434
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Entity Type | Organization
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Legal Business Name | RIVERSIDE PHYSICAL MEDICINE P.C.
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 59-61 ELMORA AVE
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City | ELIZABETH
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State | NJ
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Zip | 07202-1657
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Country | US
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Telephone | 908-469-4356
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Fax | 855-347-7879
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Provider Business Mailing Address
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Address Line | PO BOX 833
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City | RED BANK
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State | NJ
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Zip | 07701-0833
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Country | US
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Telephone | 917-648-1779
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Fax | 855-347-7879
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. GIULIO CARUSO
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Credential | DC
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Telephone | 908-469-4356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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