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NPI Code Detail

MEDICARE: SALOMON RIVERA

MEDICARE:   SALOMON  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
1174400000XSpecialist135118NY

General Provider Information

NPI Number : 1548234412
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALOMON RIVERA
Provider Business Mailing Address
First Line : 698 W 204TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10034-3027
Country : US
Telephone Number : 212-942-3830
Fax Number :
Provider Business Practice Location Address
First Line : 698 W 204TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10034-3027
Country : US
Telephone Number : 212-942-3830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/08/2007

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Directions to “ SALOMON RIVERA ” Practice Location

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