Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 305277 | NY |
NPI | 1013280551 |
---|---|
Provider Name | Lenora Rivera |
First Address | New York, NY 10022-6813 |
Second Address | New York, NY 10022-6813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2012 |
Last Update Date | 14/02/2012 |