Provider Demographics
NPI:1437023637
Name:PATINO RIVAS, EVELIN
Entity type:Individual
Prefix:
First Name:EVELIN
Middle Name:
Last Name:PATINO RIVAS
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 1:35 W PRICE ST APT 307
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4489
Mailing Address - Country:US
Mailing Address - Phone:347-394-8090
Mailing Address - Fax:
Practice Address - Street 1:8914 PARSONS BLVD FL 5
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3576
Practice Address - Country:US
Practice Address - Phone:347-394-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health