Provider Demographics
NPI:1730412800
Name:RIVIER, JENNIFER A (LMT)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:A
Last Name:RIVIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:RIVIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:4000 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3405
Mailing Address - Country:US
Mailing Address - Phone:716-834-1788
Mailing Address - Fax:
Practice Address - Street 1:4000 MAIN ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3405
Practice Address - Country:US
Practice Address - Phone:716-834-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008778-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist