Provider Demographics
NPI:1922028745
Name:NAVEDO-RIVERA, MARIA S (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:S
Last Name:NAVEDO-RIVERA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:250 S END AVE
Mailing Address - Street 2:STE 6C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1074
Mailing Address - Country:US
Mailing Address - Phone:718-205-4944
Mailing Address - Fax:718-205-5946
Practice Address - Street 1:9001A ROOSEVELT AVE
Practice Address - Street 2:2ND FL
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7938
Practice Address - Country:US
Practice Address - Phone:718-205-4944
Practice Address - Fax:718-205-5946
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY190946208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
F75797Medicare UPIN