Provider Demographics
NPI:1285136564
Name:RIVERA DIAZ, MONICA (PHD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RIVERA DIAZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-0702
Mailing Address - Country:US
Mailing Address - Phone:787-238-5504
Mailing Address - Fax:
Practice Address - Street 1:201 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:484-351-8459
Practice Address - Fax:484-351-8810
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic