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General NPI Number Information
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NPI Number | 1407348444
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Entity Type | Organization
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Legal Business Name | RIVERSKY, INC
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 2775 E 12TH ST APT 706
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City | BROOKLYN
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State | NY
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Zip | 11235-4638
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Country | US
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Telephone | 718-490-4434
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Fax | 718-615-0881
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Provider Business Mailing Address
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Address Line | 2775 E 12TH ST APT 706
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City | BROOKLYN
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State | NY
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Zip | 11235-4638
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Country | US
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Telephone | 718-490-4434
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Fax | 718-615-0881
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Authorized Official
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Title or Position | OWNER
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Name | ALEKSANDR UDLER
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Credential | MA, ED.
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Telephone | 171-849-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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