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RIVERSIDE PHYSICIAN SERVICES INC NPI 1649296286


NPI Information

NPI: 1649296286
Provider Name: RIVERSIDE PHYSICIAN SERVICES INC

Doing Business As: PENINSULA VASCULAR SURGERY

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 49D2054099

Address:
156 STRAWBERRY PLAINS RD STE A
WILLIAMSBURG, VA
ZIP 23188
Phone: (757) 229-7939
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RIVERSIDE PHYSICIAN SERVICES INC is a vascular surgery surgery in Williamsburg, VA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. RIVERSIDE PHYSICIAN SERVICES INC NPI is 1649296286. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Peninsula Vascular Surgery.

The provider's business location address is:

156 STRAWBERRY PLAINS RD STE A
WILLIAMSBURG, VA
ZIP 23188-409
Phone: (757) 229-7939
Fax: (757) 229-7897

The provider's authorized official is James Lesnick .
The authorized official title is Vice President and has the following contact phone number (757) 594-4006.

The CLIA number assigned to this NPI record is 49D2054099 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/15/2006 and was last updated on 10/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11081570046MEDICARE NSCVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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