Elba L Salamanca Rivera
Early Intervention Provider Agency in Port Jefferson Station, NY. Individual provider (NPI-1).
NPI number1619706348
StatusActive
Last updated in NPPESJul 31, 2024
Details
- NPI
- 1619706348
- Entity type
- Individual (NPI-1)
- Name
- Elba L Salamanca Rivera
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 31, 2024
- Certification date
- Jul 31, 2024
- Last updated
- Jul 31, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
| 146N00000X | Emergency Medical Technician, Basic | 429109 | NY |
Practice location
299 Hallock AvePort Jefferson Station, NY 11776-1217
Phone 631-215-3337
Mailing address
2 Campo AveSelden, NY 11784-1704
Phone 631-855-8299
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All 9 Early Intervention Provider Agency providers in Port Jefferson Station · All 1,186 providers in Port Jefferson Station
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