1124394705 NPI number — MS. RUTH VERONICA RIVIERE R.N.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124394705 NPI number — MS. RUTH VERONICA RIVIERE R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVIERE
Provider First Name:
RUTH
Provider Middle Name:
VERONICA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124394705
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5951 RIVERDALE AVE
Provider Second Line Business Mailing Address:
#422
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10471-0422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-699-8478
Provider Business Mailing Address Fax Number:
718-796-9396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 EAST 12TH STREET
Provider Second Line Business Practice Location Address:
ROOM 552
Provider Business Practice Location Address City Name:
NYC
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-995-1389
Provider Business Practice Location Address Fax Number:
212-529-9384
Provider Enumeration Date:
03/28/2012

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: 163WS0200X , with the licence number:  446613 , 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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