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NPI Code Detail

MEDICARE: SHAILYN RIVAS

MEDICARE: SHAILYN RIVAS
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
1252Y00000XEarly Intervention Provider Agency1851863241NY

General Provider Information

NPI Number : 1497613467
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAILYN RIVAS
Provider Business Mailing Address
First Line : 1425 THIERIOT AVE APT 5H
Second Line :
City : BRONX
State : NY
Zip : 10460-3815
Country : US
Telephone Number : 917-608-9754
Fax Number :
Provider Business Practice Location Address
First Line : 1425 THIERIOT AVE
Second Line :
City : BRONX
State : NY
Zip : 10460-3811
Country : US
Telephone Number : 917-608-9754
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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Directions to “ SHAILYN RIVAS ” Practice Location

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