Provider Demographics
NPI:1982855508
Name:RIVERA, RAYMOND J (PA)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:J
Last Name:RIVERA
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1 E BROAD ST STE 130
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5934
Mailing Address - Country:US
Mailing Address - Phone:484-626-0480
Mailing Address - Fax:484-896-9006
Practice Address - Street 1:3477 CORPORATE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8237
Practice Address - Country:US
Practice Address - Phone:484-626-0480
Practice Address - Fax:484-896-9002
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2024-08-14
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Provider Licenses
StateLicense IDTaxonomies
PAMA053618363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant