Individual
ILEANA MARIA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
714 COVERT AVE, NEW HYDE PARK, NY 11040-5443
(787) 347-4116
Mailing address
714 COVERT AVE, NEW HYDE PARK, NY 11040-5443
(787) 347-4116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
629595
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
081475
PR
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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