Rivera, Marcus Richard

Rivera, Marcus Richard is an individual health care provider with primary practice located at 725 Irving Ave Crouse Pob Ste. 805, Syracuse NY 13210-1603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Rivera, Marcus Richard can be contacted via phone (315) 464-8444.

Contact Information

Primary practice address
725 Irving Ave Crouse Pob Ste. 805 Syracuse NY 13210-1603
Phone: (315) 464-8444
Fax: (315) 464-8445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 255782 New York

Profile Details

NPI number 1891993218
LBN Legal business name Rivera, Marcus Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2007
Last updated Oct 20th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891993218 NPPES
New York MEDICAID 02888902

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