Individual
LAVARN RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4904 CHURCH AVE, BROOKLYN, NY 11203-3406
(718) 581-6060
Mailing address
4904 CHURCH AVE, BROOKLYN, NY 11203-3406
(718) 581-6060
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
22CA1064747
NY
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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