Doctor Name: | DR. JOSE DANIEL RIVERA |
NPI Number: | 1588800379 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 0101050936 |
Business Practice Address: | 1635 N George Mason Dr Suite 480 Arlington, VA - 222053601 |
Business Phone Number: | 7035227444 |
Business Fax Number: | |
Mailing Address: | 4710 Grand Bend Dr, CATONSVILLE |
State: | MD |
Postal Code: | 212283683 |
Phone Number: | 4102476773 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2008 |
NPI Last Update Date: | 12/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0101050936 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |