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Individual
YURI OLAF RIVERA
Active
Individual
YURI OLAF RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00120
MS
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09075224
—
MS
01
—
5300264
CIGNA
MS
01
—
9116618
AETNA
MS
Enumeration date
12/12/2006
Last updated
07/23/2020
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