MEDICARE: INNA RIVA DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MB2509984700	NJ

General Provider Information

NPI Number	:	1013327345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INNA RIVA DO

Provider Business Mailing Address
First Line	:	206 WASHINGTON ST APT 1A
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4565
Country	:	US
Telephone Number	:	408-981-7358
Fax Number	:	508-659-8262

Provider Business Practice Location Address
First Line	:	206 WASHINGTON ST APT 1A
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4565
Country	:	US
Telephone Number	:	408-981-7358
Fax Number	:	508-659-8262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	03/11/2026

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Directions to “ INNA RIVA DO” Practice Location

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