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General NPI Number Information
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NPI Number | 1740666254
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Entity Type | Organization
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Legal Business Name | RIVERVIEW PAIN & SPINE INSTITUE
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 123 FRANKLIN CORNER RD STE 104
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2526
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Country | US
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Telephone | 609-873-3005
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Fax |
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Provider Business Mailing Address
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Address Line | 123 FRANKLIN CORNER RD STE 104
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2526
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Country | US
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Telephone | 609-873-3005
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DINASH YANAMADULA
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Credential |
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Telephone | 609-873-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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