Doctor Name: | VICTOR RIZAL ALTAVAS ARCEGA |
NPI Number: | 1316309487 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 300 2nd Ave Long Branch, NJ - 077406303 |
Business Phone Number: | 7329236540 |
Business Fax Number: | 7329236536 |
Mailing Address: | 300 2nd Ave, LONG BRANCH |
State: | NJ |
Postal Code: | 077406303 |
Phone Number: | 7329236540 |
Fax Number: | 7329236536 |
NPI Enumeration Date: | 03/28/2016 |
NPI Last Update Date: | 04/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |