Provider Demographics
NPI:1760408553
Name:RIVERA, MARGARITA (RPH CGP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARITA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RPH CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1957
Mailing Address - Country:US
Mailing Address - Phone:716-862-8911
Mailing Address - Fax:716-862-6348
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8911
Practice Address - Fax:716-862-6348
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2912183500000X
NY046682-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist