| Organization Name: | RIVERSIDE PHYSICIAN SERVICES INC |
| NPI Number: | 1396999215 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES LESNICK (VICE PRESIDENT) |
| Mailing Address: | 12715 Warwick Blvd Suite H Newport News |
| State: | VA US |
| Postal Code: | 236061800 |
| Phone Number: | 7575943969 |
| Fax Number: | 7575943971 |
| NPI Enumeration Date: | 11/05/2008 |
| NPI Last Update Date: | 10/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |