Healthcare Provider Details

I. General information

NPI: 1952228629
Provider Name (Legal Business Name): PATRICIA PAOLA RIVADENEIRA CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA PAOLA MACERA CPHT

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 7TH AVE
BROOKLYN NY
11228-3236
US

IV. Provider business mailing address

1420 BATH AVE FL 2
BROOKLYN NY
11228-3805
US

V. Phone/Fax

Practice location:
  • Phone: 718-971-9400
  • Fax: 718-971-9399
Mailing address:
  • Phone: 347-446-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number005356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: