Provider Demographics
NPI:1770371882
Name:RIVERA, GABRIELE S
Entity type:Individual
Prefix:
First Name:GABRIELE
Middle Name:S
Last Name:RIVERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 AMSTERDAM AVE APT 4R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4674
Mailing Address - Country:US
Mailing Address - Phone:201-566-3077
Mailing Address - Fax:
Practice Address - Street 1:789 W END AVE APT 6C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5417
Practice Address - Country:US
Practice Address - Phone:201-566-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)