1306952007 NPI number — RIVERSIDE RADIOLOGY & INTERVENTIONAL ASSOC

Table of content: ERIN CAPPICCIE TOMER CNS, LDN (NPI 1437837481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306952007 NPI number — RIVERSIDE RADIOLOGY & INTERVENTIONAL ASSOC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIVERSIDE RADIOLOGY & INTERVENTIONAL ASSOC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306952007
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E CAMPUS VIEW BLVD
Provider Second Line Business Mailing Address:
STE 160
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43235-4647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-396-4750
Provider Business Mailing Address Fax Number:
614-396-4742

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3525 OLENTANGY RIVER RD
Provider Second Line Business Practice Location Address:
STE 5360
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43214-3937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-340-7747
Provider Business Practice Location Address Fax Number:
614-340-7742
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARRETT
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
419-294-4991

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  35-04-5959 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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