Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 029118 | CT |
NPI | 1023127917 |
---|---|
Provider Name | Nelza Rivera-Competiello |
First Address | Enfield, CT 06082 |
Second Address | Enfield, CT 06082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001291187000 | BCBS (01) | CT |
D37961 | (02) |