Provider Demographics
NPI:1992526909
Name:RIVERA ROMAN, NADIA ELENA
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:ELENA
Last Name:RIVERA ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT. TANAMA 190 CALLE EL MOLINO
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-5364
Mailing Address - Country:US
Mailing Address - Phone:939-243-5065
Mailing Address - Fax:
Practice Address - Street 1:EXT. TANAMA 190 CALLE EL MOLINO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-5364
Practice Address - Country:US
Practice Address - Phone:939-243-5065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program