MEDICARE: MISS ESMERALDA ZAFIRES RIVERA P.T.

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	2251P0200X	Pediatric Physical Therapist	023834-1	NY

General Provider Information

NPI Number	:	1265687933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ESMERALDA ZAFIRES RIVERA P.T.

Provider Business Mailing Address
First Line	:	1336 70TH ST
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11228-1628
Country	:	US
Telephone Number	:	718-331-2635
Fax Number	:	718-331-2635

Provider Business Practice Location Address
First Line	:	1311 55TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4202
Country	:	US
Telephone Number	:	718-851-6100
Fax Number	:

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

Provider Enumeration Date	:	11/22/2008
Last Update Date	:	11/22/2008

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