# JOHN E. RIVERA JR., M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southington Family Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902146996
- **Authorized official:** DR. JOHN EDWIN RIVERA JR. M.D. (OWNER)
- **Authorized official phone:** (860) 621-5554

## Contact information

- **Practice address:** 1753 MERIDEN-WATERBURY TURNPIKE, MILLDALE, CT 06467
- **Practice address phone:** (860) 621-5554
- **Practice address fax:** (860) 621-3833
- **Mailing address:** PO BOX 770, MILLDALE, CT 06467-0770
- **Mailing address phone:** (860) 621-5554
- **Mailing address fax:** (860) 621-3833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 042567 | CT | Yes |

## Other

- **Enumeration date:** 02/27/2013
- **Last updated:** 05/02/2013