Provider Demographics
NPI:1972282796
Name:RIVERA, TASHIRA
Entity type:Individual
Prefix:
First Name:TASHIRA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TASHIRA
Other - Middle Name:
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOULA
Mailing Address - Street 1:1827 CLEMENT WAY
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08104-2435
Mailing Address - Country:US
Mailing Address - Phone:856-283-1306
Mailing Address - Fax:
Practice Address - Street 1:1827 CLEMENT WAY
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-2435
Practice Address - Country:US
Practice Address - Phone:856-283-1306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula