Individual
BRENDALY RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
15 CHADDUCK AVE, BUFFALO, NY 14207-1555
(716) 423-4080
Mailing address
15 CHADDUCK AVE, BUFFALO, NY 14207-1555
(716) 423-4080
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
937250616
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
937250616
DRIVER LICENSE
NY
Enumeration date
03/22/2021
Last updated
03/22/2021
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