Individual
DR. JAIME HERNAN RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 FULTON AVE, POUGHKEEPSIE, NY 12603-2808
(845) 452-1700
Mailing address
104 FULTON AVE, POUGHKEEPSIE, NY 12603-2808
(845) 452-1700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
131829
NY
208000000X
Pediatrics Physician
Primary
131829
NY
208000000X
Pediatrics Physician
C1-0002870
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000028901
—
DE
05
—
00249707
—
NY
Enumeration date
12/09/2006
Last updated
03/21/2019
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