Individual
DR. CARLOS J. RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
122 W ROE BLVD, PATCHOGUE, NY 11772-2569
(631) 504-6261
(631) 504-6263
Mailing address
8 GEORGANN RD, MANORVILLE, NY 11949-3223
(631) 504-6261
(631) 504-6263
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
221385
NY
Other
Enumeration date
05/03/2006
Last updated
03/18/2009
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