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Individual

DR. JUAN ANGEL LEONIDAS RIVOLTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
411 THEODORE FREMD AVE, SUITE 206 SOUTH, RYE, NY 10580-1411
(917) 685-2419
(917) 905-1993
Mailing address
38 HOWELL AVE, LARCHMONT, NY 10538-3249
(917) 685-2419
(917) 905-1993

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
292297
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982014833
NY
01
292297
NYS LICENSE
NY
Enumeration date
04/30/2014
Last updated
06/15/2025
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