1447790928 NPI number — ALFREDO ERASMO LAMBOY RIVERA M.A.

Table of content: ALFREDO ERASMO LAMBOY RIVERA M.A. (NPI 1447790928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447790928 NPI number — ALFREDO ERASMO LAMBOY RIVERA M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMBOY RIVERA
Provider First Name:
ALFREDO
Provider Middle Name:
ERASMO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
M

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:
1447790928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 AVE DEL ESPIRITU SANTO
Provider Second Line Business Mailing Address:
APTO 7-504
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00725-3061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 AVE DEL ESPIRITU SANTO
Provider Second Line Business Practice Location Address:
APTO 7-504
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-3061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-678-9667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2017

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: 103TC1900X , with the licence number:  5681 , 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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