Individual
JEFFREY RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 COOPER CT, STONY BROOK, NY 11790-1303
(631) 894-7147
Mailing address
3 COOPER CT, STONY BROOK, NY 11790-1303
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011528-1
NY
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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