Provider Demographics
NPI:1336452333
Name:RIVERA, RACHELLE (MD)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:780 KUENZLI ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0845
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:75 PRINGLE WAY
Practice Address - Street 2:SUITE 512
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1464
Practice Address - Country:US
Practice Address - Phone:775-982-3866
Practice Address - Fax:775-982-3868
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2016-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301097339207R00000X
NV16291207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine