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NPI Code Detail

MEDICARE: MR. JULIAN J RIVERA LMSW

MEDICARE:  MR. JULIAN J RIVERA  LMSW
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
11041C0700XClinical Social Worker045579NY

General Provider Information

NPI Number : 1134287402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JULIAN J RIVERA LMSW
Provider Business Mailing Address
First Line : 85 LINVINGSTON ST
Second Line : PHF
City : BROOKLYN
State : NY
Zip : 11201-5031
Country : US
Telephone Number : 718-596-1791
Fax Number :
Provider Business Practice Location Address
First Line : OCNI 3764 72ND ST
Second Line :
City : JACKSON HTS
State : NY
Zip : 11372-6143
Country : US
Telephone Number : 718-335-3434
Fax Number : 718-335-4731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JULIAN J RIVERA LMSW” Practice Location

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