Individual
MICHAEL RIVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210
(315) 464-5540
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
294013
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2016
Last updated
07/12/2018
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