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NPI Code Detail

MEDICARE: DR. DONNA LEE RIVERA PH.D.

MEDICARE:  DR. DONNA LEE RIVERA  PH.D.
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
1103TC0700XClinical Psychologist014118NY

General Provider Information

NPI Number : 1841380128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONNA LEE RIVERA PH.D.
Provider Business Mailing Address
First Line : 761 49TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-2206
Country : US
Telephone Number : 718-436-5523
Fax Number : 718-436-5523
Provider Business Practice Location Address
First Line : 1048 49TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2917
Country : US
Telephone Number : 917-991-0774
Fax Number : 718-436-5523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DONNA LEE RIVERA PH.D.” Practice Location

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