Organization
CLARA M. RIVERA PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA M RIVERA (SOLE PROPRIETER)
(718) 261-1759
Entity
Organization
Contact information
Practice address
11247 QUEENS BLVD, SUITE 106, FOREST HILLS, NY 11375-7417
(718) 261-1759
Mailing address
11247 QUEENS BLVD, SUITE 106, FOREST HILLS, NY 11375-7417
(718) 261-1759
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
161107
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01055009
—
NY
Enumeration date
01/17/2006
Last updated
11/01/2010
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