DOMINGO A RIVERA-LAKE

BRONX, NY
NPI1225165319
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  009922)
Enumeration Date2007-02-27
Last Update Date2007-07-08
Business Address
DOMINGO A RIVERA-LAKE PA
111 E 210TH ST MMC - DEPT OF RADIOLOGY
BRONX, NY 10467-2401
Phone number: 866-662-9729
Mailing Address
DOMINGO A RIVERA-LAKE PA
6 DUNE CT APT 1
BRONX, NY 10473-1662
Phone number: 866-662-9729
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