1912938937 NPI number — MRS. ROBIN GAIL RIVERA FNP -BC

Table of content: MRS. ROBIN GAIL RIVERA FNP -BC (NPI 1912938937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912938937 NPI number — MRS. ROBIN GAIL RIVERA FNP -BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA
Provider First Name:
ROBIN
Provider Middle Name:
GAIL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP -BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HECKLER
Provider Other First Name:
ROBIN
Provider Other Middle Name:
GAIL
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912938937
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
737 CRAFT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN SQUARE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11010-3210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-451-8682
Provider Business Mailing Address Fax Number:
718-235-1087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
999 JAMAICA AVE
Provider Second Line Business Practice Location Address:
FRANKLIN K LANE HS HEALTH CENTER
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11208-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-235-1087
Provider Business Practice Location Address Fax Number:
718-235-1291
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  F334959 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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