Provider Demographics
NPI:1912938937
Name:RIVERA, ROBIN GAIL (FNP -BC)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:GAIL
Last Name:RIVERA
Suffix:
Gender:F
Credentials:FNP -BC
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:GAIL
Other - Last Name:HECKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:737 CRAFT AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3210
Mailing Address - Country:US
Mailing Address - Phone:516-451-8682
Mailing Address - Fax:718-235-1087
Practice Address - Street 1:999 JAMAICA AVE
Practice Address - Street 2:FRANKLIN K LANE HS HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1503
Practice Address - Country:US
Practice Address - Phone:718-235-1087
Practice Address - Fax:718-235-1291
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily