Most Relevant Information
Provider Data
| NPI Number: | 1003209198 |
| Provider Name: | MICHAEL A. RIVERA L.C.S.W. |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 7912 |
Most Important Dates
| Enumeration Date: | 03/12/2015 |
| Last Updated: | 06/14/2022 |
Provider Practice Location
27 PATRIOTS SQ
MANSFIELD CENTER
CT
062501517
Practice Location Phone/Fax
| Phone: | 8607524249 |
| Fax: |
Provider Mailing Location
27 PATRIOTS SQ
MANSFIELD CENTER
CT
062501517
Provider Mailing Phone/Fax
| Phone: | 8607524249 |
| Fax: |