Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | CH6846 | FL |
Y | 111NN0400X | Neurology | X009571-1 | NY |
NPI | 1487893293 |
---|---|
Provider Name | Dr. Zechariah Rivietz |
First Address | New York, NY 10021-3208 |
Second Address | New York, NY 10021-3208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 18/02/2009 |