Provider Demographics
NPI:1558734996
Name:RIVERA, ELSY (FNP)
Entity type:Individual
Prefix:MISS
First Name:ELSY
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17004 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2745
Mailing Address - Country:US
Mailing Address - Phone:917-776-7909
Mailing Address - Fax:
Practice Address - Street 1:8801 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3841
Practice Address - Country:US
Practice Address - Phone:718-526-3400
Practice Address - Fax:205-857-7920
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340152-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily