Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N006721 | NY |
NPI | 1093111866 |
---|---|
Provider Name | Dr. Mariola Rivera Morell |
First Address | New York, NY 10128-1111 |
Second Address | New York, NY 10128-1111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2014 |
Last Update Date | 16/08/2015 |