Individual
CRAIG RIVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 E FAIRMOUNT AVE, LAKEWOOD, NY 14750
(716) 526-0156
(716) 708-1578
Mailing address
PO BOX 500, ELLICOTTVILLE, NY 14731-0500
(716) 699-9032
(716) 699-9035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022362
NY
363A00000X
Physician Assistant
MA057397
PA
363A00000X
Physician Assistant
OA003464
PA
Other
Enumeration date
01/07/2015
Last updated
08/05/2025
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