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General NPI Number Information
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NPI Number | 1710020623
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Entity Type | Organization
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Legal Business Name | RIVERSIDE PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 856 J CLYDE MORRIS BLVD SUITE A
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1318
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Country | US
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Telephone | 757-594-4006
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Fax | 757-534-5190
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Provider Business Mailing Address
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Address Line | PO BOX 826608
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City | PHILADELPHIA
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State | PA
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Zip | 19182-6608
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Country | US
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Telephone | 757-316-5888
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Fax | 754-594-4005
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JAMES LESNICK
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Credential | MD
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Telephone | 757-594-4006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | VA
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Taxonomy #8
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | VA
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Taxonomy #9
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State | VA
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Taxonomy #10
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #11
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #12
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | VA
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Taxonomy #13
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State | VA
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Taxonomy #14
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State | VA
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | VA
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