Provider Demographics
NPI:1306137807
Name:RIVERA, CHRISTINE YANIRE (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:YANIRE
Last Name:RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 PROSPECT AVE
Mailing Address - Street 2:APT 3J
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2615
Mailing Address - Country:US
Mailing Address - Phone:860-371-0409
Mailing Address - Fax:
Practice Address - Street 1:326 PROSPECT AVE
Practice Address - Street 2:APT 3J
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2615
Practice Address - Country:US
Practice Address - Phone:860-371-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3325111N00000X
NY012324111N00000X
NJ38MC00714800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor