MEDICARE: DR. VANESSA ALTIERI M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	14987	PR

General Provider Information

NPI Number	:	1245393594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA ALTIERI M.D

Provider Business Mailing Address
First Line	:	5-19 AVE SANTA ANA
Second Line	:	URB. ALTURAS DE TORRIMAR
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3210
Country	:	US
Telephone Number	:	787-306-6359
Fax Number	:

Provider Business Practice Location Address
First Line	:	5-19 AVE SANTA ANA
Second Line	:	URB. ALTURAS DE TORRIMAR
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3210
Country	:	US
Telephone Number	:	787-306-6359
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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