Individual
MS. AMANDA TRACY RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
109 W 27TH ST RM 5S, NEW YORK, NY 10001-6208
(833) 351-8255
(888) 815-3583
Mailing address
112 LEYDECKER RD, WEST SENECA, NY 14224-4518
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
676126
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402924
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
676126
REGISTERED PROFESSIONAL NURSE LICENCE
NY
01
—
F402924
NURSE PRACTITIONER IN PSYCHIATRY
NY
Enumeration date
10/17/2017
Last updated
03/03/2026
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