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NPI Code Detail

MEDICARE: RENE RIVERA LCSW-R

MEDICARE: RENE RIVERA LCSW-R
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 Worker084687NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669723375
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENE RIVERA LCSW-R
Provider Business Mailing Address
First Line : 50 W SUNRISE HWY # 1077
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11581-1104
Country : US
Telephone Number : 929-855-1545
Fax Number :
Provider Business Practice Location Address
First Line : 3708 91ST ST STE 300
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7961
Country : US
Telephone Number : 718-779-2263
Fax Number : 718-277-0822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2012
Last Update Date : 10/04/2022

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Directions to “ RENE RIVERA LCSW-R” Practice Location

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