Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD9236 | RI |
NPI | 1013930536 |
---|---|
Provider Name | David R. Rivera |
First Address | Westerly, RI 02891-2927 |
Second Address | Westerly, RI 02891-2927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003099638 | (05) | CT |
7058937 | (05) | RI |
G29988 | (02) | RI |