MEDICARE: LOIDA S 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
1	171M00000X	Case Manager/Care Coordinator
2	235Z00000X	Speech-Language Pathologist	SA23616	FL

General Provider Information

NPI Number	:	1659794717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIDA S RIVERA

Provider Business Mailing Address
First Line	:	45 WADSWORTH TER APT 1I
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-2922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 WADSWORTH TER APT 1I
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-2922
Country	:	US
Telephone Number	:	646-515-4144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2014
Last Update Date	:	02/10/2026

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Directions to “ LOIDA S RIVERA ” Practice Location

Language	Start Address	Practice Location

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