Provider Demographics
NPI:1831454073
Name:RIVERA, CYNTHIA (MSED)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 LITTLE BRITAIN RD
Mailing Address - Street 2:
Mailing Address - City:ROCK TAVERN
Mailing Address - State:NY
Mailing Address - Zip Code:12575-5343
Mailing Address - Country:US
Mailing Address - Phone:917-575-0598
Mailing Address - Fax:
Practice Address - Street 1:2021 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:ROCK TAVERN
Practice Address - State:NY
Practice Address - Zip Code:12575-5343
Practice Address - Country:US
Practice Address - Phone:917-575-0598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist