1255574968 NPI number — DR. GERALDINNE NAHIR LOPEZ-RIVERA PH.D.

Table of content: DR. GERALDINNE NAHIR LOPEZ-RIVERA PH.D. (NPI 1255574968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255574968 NPI number — DR. GERALDINNE NAHIR LOPEZ-RIVERA PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOPEZ-RIVERA
Provider First Name:
GERALDINNE
Provider Middle Name:
NAHIR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255574968
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6400 PMB 180
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAYEY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-731-2191
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FRACCLONAMIENTO TUMBEN CHILAM CALLE CHAC
Provider Second Line Business Practice Location Address:
MANZANA 29 LOTE 18
Provider Business Practice Location Address City Name:
PLAYA DEL CARMEN
Provider Business Practice Location Address State Name:
QUINTANA ROO
Provider Business Practice Location Address Postal Code:
77725
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
303-731-2191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TS0200X , with the licence number:  3254 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , with the licence number: 251631 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , with the licence number: 96639 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , with the licence number: 10443613 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)