Rider, Russell E
Rider, Russell E is an sole proprietor health care provider with primary practice located at 8561 Newcomb Rd , Long Lake NY 12847-0129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rider, Russell E can be contacted via phone (518) 624-2301.Contact Information
Primary practice address
8561 Newcomb Rd
Long Lake NY 12847-0129
Phone: (518) 624-2301
Fax: (518) 624-2043
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1712651 | New York |
Profile Details
| NPI number | 1245244649 |
|---|---|
| LBN Legal business name | Rider, Russell E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2006 |
| Last updated | Sep 11th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245244649 | NPPES |
| New York | MEDICAID | 01110874 |
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