Provider Demographics
NPI:1235294125
Name:NAVA, CESAR RIVERAL JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:RIVERAL
Last Name:NAVA
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 N BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WEST WAYNE PLAZA
Practice Address - Street 2:1900 ROUTE 31
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502
Practice Address - Country:US
Practice Address - Phone:315-986-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001404-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer