Provider Demographics
NPI:1851707558
Name:MARRERO RIVERA, GISELA
Entity type:Individual
Prefix:
First Name:GISELA
Middle Name:
Last Name:MARRERO RIVERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BERRY ST STE 290
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1773
Mailing Address - Country:US
Mailing Address - Phone:415-353-1667
Mailing Address - Fax:415-353-1106
Practice Address - Street 1:185 BERRY ST STE 290
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1773
Practice Address - Country:US
Practice Address - Phone:415-353-1667
Practice Address - Fax:415-353-1106
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172593207ZC0006X, 207ZB0001X, 2080P0207X
PR00000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology