Most Relevant Information
Provider Data
| NPI Number: | 1003458019 |
| Provider Name: | EDDYLANE ROSIO RIVERA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/10/2019 |
| Last Updated: | 10/10/2019 |
Provider Practice Location
3651 BELL BLVD
BAYSIDE
NY
113612169
Practice Location Phone/Fax
| Phone: | 7188198623 |
| Fax: |
Provider Mailing Location
3651 BELL BLVD STE 209
BAYSIDE
NY
113612025
Provider Mailing Phone/Fax
| Phone: | 7188198623 |
| Fax: | 3478368305 |