Provider Demographics
NPI:1316260300
Name:RIVAS, YVERCA R (RN)
Entity type:Individual
Prefix:MISS
First Name:YVERCA
Middle Name:R
Last Name:RIVAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1403
Mailing Address - Country:US
Mailing Address - Phone:631-921-5723
Mailing Address - Fax:
Practice Address - Street 1:407 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:EAST YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11967-1403
Practice Address - Country:US
Practice Address - Phone:631-921-5723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-05
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY626435163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical