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NPI Code Detail

MEDICARE: NICOLE RIVERA

MEDICARE: NICOLE RIVERA
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
1104100000XSocial Worker
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1023745825
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE RIVERA
Provider Business Mailing Address
First Line : 2710 WEBB AVE APT 5H
Second Line :
City : BRONX
State : NY
Zip : 10468-3289
Country : US
Telephone Number : 347-859-9151
Fax Number :
Provider Business Practice Location Address
First Line : 579 COURTLANDT AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-5013
Country : US
Telephone Number : 718-485-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2022
Last Update Date : 06/09/2026

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Directions to “ NICOLE RIVERA ” Practice Location

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