Basic Information
| Provider Information | |||||||||
| NPI: | 1841424744 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIVERSIDE REGIONAL MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 J CLYDE MORRIS BLVD. | ||||||||
| Address2: | RIVERSIDE REGIONAL MEDICAL CENTER | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236013102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575944737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10510 JEFFERSON AVE. SUID D | ||||||||
| Address2: | BRENTWOOD OB GYN | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236013102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575944737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2009 | ||||||||
| LastUpdateDate: | 05/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | RABADIYA | ||||||||
| AuthorizedOfficialFirstName: | NIKUNJKUMAR | ||||||||
| AuthorizedOfficialMiddleName: | MADHUBHAI | ||||||||
| AuthorizedOfficialTitleorPosition: | OB-GYN RESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7575944737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X | 0116020091 | VA | Y | Hospitals | General Acute Care Hospital | Women |
No ID Information.