Provider Demographics
NPI:1043566763
Name:RIVERA TODARO, LEA
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:
Last Name:RIVERA TODARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ROUSNER LN
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-4512
Mailing Address - Country:US
Mailing Address - Phone:718-450-2694
Mailing Address - Fax:
Practice Address - Street 1:32 COURT ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4421
Practice Address - Country:US
Practice Address - Phone:718-450-2694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN