Provider Demographics
NPI:1932786936
Name:RIVERA, PAULINE FRANCES
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:FRANCES
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 GREENLAWN ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-2952
Mailing Address - Country:US
Mailing Address - Phone:860-913-6179
Mailing Address - Fax:
Practice Address - Street 1:101 W 123RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5511
Practice Address - Country:US
Practice Address - Phone:212-662-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator