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Contact Information

CRAIG RIVINA
390 E FAIRMOUNT AVE
LAKEWOOD, NY14750
 Phone: 716-526-0156
 Fax: 716-708-1578
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CRAIG RIVINA · (Male)

NPI # 1699163147
Status Active
Credentials
Entity Individual
Enumeration date 01/07/2015
Last updated 08/05/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • NY License # 022362
  • PA License # MA057397
  • PA License # OA003464
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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