Individual
MR. RAFAEL RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
(718) 667-2386
Mailing address
777 SEAVIEW AVE, STATEN ISLAND, NY 10305-3409
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
612137
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
612137
—
NJ
Enumeration date
01/02/2018
Last updated
01/02/2018
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