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General NPI Number Information
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NPI Number | 1679300420
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Entity Type | Organization
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Legal Business Name | RIVERSIDE PEDIATRIC URGENT CARE PLLC
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 18 HIGHLAND AVE
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City | NEWBURYPORT
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State | MA
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Zip | 01950-3883
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Country | US
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Telephone | 978-465-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 15 EAGLE ST
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City | NEWBURYPORT
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State | MA
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Zip | 01950-2207
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JENNIFER PILZ
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Credential |
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Telephone | 978-518-5327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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