Individual
MR. MANUEL RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
60 4TH ST, MERIDEN, CT 06451-4009
(203) 715-4290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5467
CT
Other
Enumeration date
10/09/2020
Last updated
12/23/2021
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