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General NPI Number Information
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NPI Number | 1174810147
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Entity Type | Individual
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Provider Name | AKEISHA LA TOYA RIVERA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 800 WESTCHESTER AVE STE N641
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City | RYE BROOK
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State | NY
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Zip | 10573
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Country | US
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Telephone | 914-231-0362
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Fax |
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Provider Business Mailing Address
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Address Line | 34 RAMONA RD
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City | NEWBURGH
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State | NY
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Zip | 12550-7010
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Country | US
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Telephone | 720-425-1321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 020809
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License Number State | NY
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