Provider Demographics
NPI:1487461281
Name:RIVERA GROUP
Entity type:Organization
Organization Name:RIVERA GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:TOLENTINO
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPT
Authorized Official - Phone:859-810-1597
Mailing Address - Street 1:3119 33RD ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2011
Mailing Address - Country:US
Mailing Address - Phone:859-810-1597
Mailing Address - Fax:
Practice Address - Street 1:3119 33RD ST APT 1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2011
Practice Address - Country:US
Practice Address - Phone:859-810-1597
Practice Address - Fax:347-867-8922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty