Provider Demographics
NPI:1447080858
Name:RIVERWAY MEDICAL PLLC
Entity type:Organization
Organization Name:RIVERWAY MEDICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYS
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-SHAER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-505-8181
Mailing Address - Street 1:108 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1106
Mailing Address - Country:US
Mailing Address - Phone:845-593-9682
Mailing Address - Fax:845-237-5917
Practice Address - Street 1:108 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1106
Practice Address - Country:US
Practice Address - Phone:845-593-9682
Practice Address - Fax:845-237-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty