MEDICARE: RIVERVIEW MEDICAL ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	NONE REQUIRED	NJ
2	207RG0100X	Gastroenterology Physician	NONE REQUIRED	NJ
3	207R00000X	Internal Medicine Physician	NON REQUIRED	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194722694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW MEDICAL ASSOCIATES PA

Provider Business Mailing Address
First Line	:	PO BOX 249
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-0249
Country	:	US
Telephone Number	:	732-741-3600
Fax Number	:	732-741-6079

Provider Business Practice Location Address
First Line	:	4 HARTFORD DR STE 1
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4945
Country	:	US
Telephone Number	:	732-741-3600
Fax Number	:	732-741-6079

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID I DROUT
Credential	:	MD
Telephone Number	:	732-741-3600

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/23/2009

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Directions to “RIVERVIEW MEDICAL ASSOCIATES PA ” Practice Location

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