Provider Demographics
NPI:1699711002
Name:RIVERSIDE PEDIATRICS INC
Entity type:Organization
Organization Name:RIVERSIDE PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-434-8009
Mailing Address - Street 1:50 AMARAL ST
Mailing Address - Street 2:
Mailing Address - City:E PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02915
Mailing Address - Country:US
Mailing Address - Phone:401-434-8009
Mailing Address - Fax:401-435-3634
Practice Address - Street 1:50 AMARAL ST
Practice Address - Street 2:
Practice Address - City:E PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02915
Practice Address - Country:US
Practice Address - Phone:401-434-8009
Practice Address - Fax:401-435-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty