Provider Demographics
NPI:1568938942
Name:GOTTEHRER, RIVKA (MSED)
Entity Type:Individual
Prefix:
First Name:RIVKA
Middle Name:
Last Name:GOTTEHRER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-6061
Mailing Address - Country:US
Mailing Address - Phone:347-415-5467
Mailing Address - Fax:
Practice Address - Street 1:712 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5406
Practice Address - Country:US
Practice Address - Phone:718-858-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist