Individual
MARCUS RICHARD RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 IRVING AVE, CROUSE POB STE. 805, SYRACUSE, NY 13210-1603
(315) 464-8444
(315) 464-8445
Mailing address
725 IRVING AVE, CROUSE POB STE. 805, SYRACUSE, NY 13210-1603
(315) 464-8444
(315) 464-8445
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
255782
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02888902
—
NY
Enumeration date
07/06/2007
Last updated
10/20/2010
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