Individual
DR. LLISENIA E. RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1940 GRAND CONCOURSE, BRONX, NY 10457-5221
(718) 583-6347
Mailing address
86 LONGVIEW AVE, HACKENSACK, NJ 07601-1807
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
053658
NY
Other
Enumeration date
08/20/2007
Last updated
09/07/2007
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