Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00696800 | NJ |
N | 111NN1001X | Nutrition | 38MC00696800 | NJ |
NPI | 1235436718 |
---|---|
Provider Name | Dr. Nicole Claire Rivera |
First Address | Belmar, NJ 07719 |
Second Address | Belmar, NJ 07719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2011 |
Last Update Date | 10/09/2015 |