Organization
CARLOS G RIVERA M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SWOOPE (MANAGER)
(732) 977-4946
Entity
Organization
Contact information
Practice address
9 MEMORIAL PKWY, LONG BRANCH, NJ 07740-6701
(732) 728-7010
Mailing address
9 MEMORIAL PKWY, LONG BRANCH, NJ 07740-6701
(732) 728-7010
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
25MA06184200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6635008
—
NJ
Enumeration date
05/20/2013
Last updated
05/20/2013
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