Individual
TARA RIVERA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3626 ROUTE 1 N, PRINCETON, NJ 08540-5922
(609) 243-0445
(609) 452-7577
Mailing address
401 RIDGE RD, SUITE 6, DAYTON, NJ 08810-3300
(732) 329-4800
(732) 329-0445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB07195500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8291201
—
NJ
Enumeration date
05/23/2006
Last updated
07/08/2007
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