Provider Demographics
NPI:1124570759
Name:RIVERA-TORRES, PAOLA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAOLA
Middle Name:M
Last Name:RIVERA-TORRES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-3519
Mailing Address - Country:US
Mailing Address - Phone:212-387-8299
Mailing Address - Fax:212-387-7432
Practice Address - Street 1:540 E 13TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3519
Practice Address - Country:US
Practice Address - Phone:212-387-8299
Practice Address - Fax:212-387-7432
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY022538103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1124570759Medicaid