Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 303735 | NY |
NPI | 1548303035 |
---|---|
Provider Name | Mrs. Amber Marie Rivera |
First Address | Syracuse, NY 13203-1807 |
Second Address | Syracuse, NY 13203-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 13/05/2015 |