Individual
DR. E. VICTORIA RUNDBERG-RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
SUNY PUTNAM HALL RM 103, STONY BROOK, NY 11794-0001
(631) 632-8850
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 632-8850
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
213013
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02049012
—
NY
Enumeration date
06/15/2006
Last updated
06/04/2008
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