Individual
MR. JOSE LUIS RIVERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
458 GRAND AVE, NEW HAVEN, CT 06513-3856
(203) 752-1212
Mailing address
89 CENTER ST FL 2, BRIDGEPORT, CT 06604-3312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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