1801931183 NPI number — MRS. CARMEN CECILIA NERIS LPN

Table of content: MRS. CARMEN CECILIA NERIS LPN (NPI 1801931183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801931183 NPI number — MRS. CARMEN CECILIA NERIS LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NERIS
Provider First Name:
CARMEN
Provider Middle Name:
CECILIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPN
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:
1801931183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1295 112
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN LORENZO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-423-9612
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE FRANCISIO CNZ #2
Provider Second Line Business Practice Location Address:
BOX 1330 COSSMA
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-739-8182
Provider Business Practice Location Address Fax Number:
787-739-8190
Provider Enumeration Date:
02/21/2007

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: 164W00000X , with the licence number:  28342 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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