Provider Demographics
NPI:1104689546
Name:NEGRIN RIVERA, ELEAN
Entity type:Individual
Prefix:
First Name:ELEAN
Middle Name:
Last Name:NEGRIN RIVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MD10 PLAZA 9
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4733
Mailing Address - Country:US
Mailing Address - Phone:939-331-8887
Mailing Address - Fax:
Practice Address - Street 1:MD10 PLAZA 9
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4733
Practice Address - Country:US
Practice Address - Phone:939-331-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program