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Individual

ALYSSA RIVERA I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
538 BROADHOLLOW RD, MELVILLE, NY 11747-3676
(631) 385-7780
Mailing address
24 JUSTIN CIR, PORT JEFFERSON STATION, NY 11776-4290
(631) 796-6484

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
05/31/2016
Last updated
05/31/2016
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