MEDICARE: LEAH RESHMA 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1780549873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH RESHMA RIVERA

Provider Business Mailing Address
First Line	:	314 E 236TH ST APT 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10470-2184
Country	:	US
Telephone Number	:	646-894-3994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 EDWARD L GRANT HWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-3144
Country	:	US
Telephone Number	:	478-388-2497
Fax Number	:

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

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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Directions to “ LEAH RESHMA RIVERA ” Practice Location

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