Provider Demographics
NPI:1548383946
Name:RIVERA, ARISTOTLE R (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ARISTOTLE
Middle Name:R
Last Name:RIVERA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KIRKPATRICK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4071
Mailing Address - Country:US
Mailing Address - Phone:732-545-0494
Mailing Address - Fax:732-545-0498
Practice Address - Street 1:100 KIRKPATRICK ST STE 201
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-4071
Practice Address - Country:US
Practice Address - Phone:732-545-0494
Practice Address - Fax:732-545-0498
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NJPT40QA00857100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty