MEDICARE: DR. LUZ M RIVERA O.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	152W00000X	Optometrist	OEG000834	PA

General Provider Information

NPI Number	:	1770696494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUZ M RIVERA O.D.

Provider Business Mailing Address
First Line	:	32 E GERMANTOWN PIKE
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19401-1512
Country	:	US
Telephone Number	:	610-272-1440
Fax Number	:	610-272-1441

Provider Business Practice Location Address
First Line	:	32 E GERMANTOWN PIKE
Second Line	:
City	:	EAST NORRITON
State	:	PA
Zip	:	19401-1512
Country	:	US
Telephone Number	:	610-272-1440
Fax Number	:	610-272-1441

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	08/02/2010

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