Provider Demographics
NPI:1679701965
Name:RIVKIN, ALINA (SLP)
Entity type:Individual
Prefix:MRS
First Name:ALINA
Middle Name:
Last Name:RIVKIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18555 OCEAN MIST DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4907
Mailing Address - Country:US
Mailing Address - Phone:718-644-5685
Mailing Address - Fax:
Practice Address - Street 1:18555 OCEAN MIST DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4907
Practice Address - Country:US
Practice Address - Phone:718-644-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017896235Z00000X
FLSA12679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist