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General NPI Number Information
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NPI Number | 1750162053
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Entity Type | Individual
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Provider Name | DANIEL RIVERA
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Gender | Male
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 66 SUNSET STRIP STE 302
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1362
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Country | US
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Telephone | 862-707-2469
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SANDRA LN
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City | RANDOLPH
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State | NJ
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Zip | 07869-1547
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Country | US
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Telephone | 862-599-0867
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 44SL06989200
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License Number State | NJ
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