Provider Demographics
NPI:1114199668
Name:RIVERA, DEBORA DELOCCO (RN)
Entity type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:DELOCCO
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3430
Mailing Address - Country:US
Mailing Address - Phone:203-468-0389
Mailing Address - Fax:203-468-0389
Practice Address - Street 1:152 VISTA DR
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-3430
Practice Address - Country:US
Practice Address - Phone:203-468-0389
Practice Address - Fax:203-468-0389
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT067491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse