Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 3024 | PR |
NPI | 1023195245 |
---|---|
Provider Name | Dr. Angel Manuel Rivera |
First Address | Hato Rey, PR 00918-3725 |
Second Address | Hato Rey, PR 00918-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C78034 | (02) |