RIVERSIDE REHAB, INC. (NPI# 1881880540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881880540 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE REHAB, INC. |
| Other Organization Name | RIVERSIDE CHIROPRACTIC & PHYSICAL REHABILITATION |
| Practice Address |
200 E Girard Ave Phila PA 19125-3917 |
| Practice Telephone | 2152911578 |
| Practice Fax Number | 2152914262 |
| Mailing Telephone | 2152911578 |
| Mailing Fax Number | 2152914262 |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2007-09-17 |
| Authorized Official Name | DAVID BODOF (OWNER) |
| Authorized Official Telephone | 2152911578 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC006859L | PA | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Riverside Chiropractic & Physical Rehabilitation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922167279 | Riverside Rehab, Inc. | Counselor | 7735 W Riverside Dr, Boise, ID 83714-6182 | 2006-12-06 |
| Street Address |
200 E GIRARD AVE |
| City | PHILA |
| State | PA |
| Zip Code | 19125-3917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073563664 | David Scott Bodoff | Chiropractor | 200 E Girard Ave, Phila, PA 19125-3917 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194241810 | Latiana Ridgell | Registered Nurse | 1080 N. Delaware Ave, Suite 300d, Phildelphia, PA 19125 | 2017-08-15 |
| 1659800175 | Michael William Pelekanos | Psychiatry & Neurology | 100 E. Lehigh Avenue Suite 305b, Philadelphia, PA 19125 | 2017-06-08 |
| 1063940187 | Travis J Dichoso | Psychiatry & Neurology | 100 E Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2017-06-02 |
| 1891232419 | Kristin Marie Iannuzzelli | Counselor | 1114 Earl Street, Philadelphia, PA 19125 | 2017-01-20 |
| 1811440399 | Temple University Hospital | Psychiatric Hospital | 100 East Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2016-08-01 |
| 1518343359 | Tamer Hassan Zayed Moustafa | Dentist | 100 E Lehigh Ave # Pm2, Philadelphia, PA 19125 | 2015-08-04 |
| 1235564337 | Ron Benjamin | Radiology | 2055 E Fletcher St, Philadelphia, PA 19125 | 2013-09-08 |
| 1457799165 | Ross Andrew Levine | Dentist | 100 E. Lehigh Ave, Pedatric Dental Associates, Philadelphia, PA 19125 | 2013-06-05 |
| 1518228543 | Kristen Kathleen Howland | Occupational Therapist | 404 East Flora St, Philadelphia, PA 19125 | 2012-06-06 |
| 1447539754 | Kiran Majeed | Psychiatry & Neurology | 100 E. Lehigh Aveune, Suite # 105, Philadelphia, PA 19125 | 2011-08-04 |
| Find all providers in zip 19125 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629257779 | Spring Chiropractic | Chiropractor | 7707 Ogontz Ave, Phila, PA 19150-1818 | 2007-10-25 |
| 1003930306 | David R Yurescko | Chiropractor | 3817 Pearson Ave, Phila, PA 19114-2832 | 2007-03-19 |
| 1861560641 | Donna M Skerry | Chiropractor | 6600 Roosevelt Blvd, Phila, PA 19149-2409 | 2006-12-01 |
| 1770656902 | Sky Monarch | Chiropractor | 553 W Clapier St, Phila, PA 19144 | 2006-11-16 |
| 1669541900 | Larry Moses | Chiropractor | 4024 Tyson Ave, Phila, PA 19135-1608 | 2006-11-08 |
| 1992896963 | James John Demarino | Chiropractor | 2505 S Broad St, Phila, PA 19148 | 2006-09-27 |
| 1720184245 | Ralph J Demarino | Chiropractor | 333 Bainbridge St, 1st Floor, Phila, PA 19147 | 2006-09-15 |
| 1750391744 | Bertram Jacobson | Chiropractor | 9500 Northeast Ave, Ste 1, Phila, PA 19115 | 2006-08-09 |
| 1710907712 | Mark Brown | Chiropractor | 1306 Cottman Ave, Phila, PA 19111-3606 | 2006-07-20 |
| 1073563664 | David Scott Bodoff | Chiropractor | 200 E Girard Ave, Phila, PA 19125-3917 | 2006-05-12 |
| Find all providers in PHILA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.