Provider Demographics
NPI:1922166206
Name:RIVELLI, CHRISTA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:LYNN
Last Name:RIVELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1512
Mailing Address - Country:US
Mailing Address - Phone:518-453-9252
Mailing Address - Fax:518-453-9252
Practice Address - Street 1:485 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1512
Practice Address - Country:US
Practice Address - Phone:518-453-9252
Practice Address - Fax:518-453-9252
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005444 1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00275238OtherRAIL ROAD MEDICARE
NYX0878OtherEMPIRE BLUE CROSS BLUE SH
NY51842BMedicare ID - Type Unspecified