Healthcare Provider Details

I. General information

NPI: 1871729459
Provider Name (Legal Business Name): FELIX DONES RIVERA JR. RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 MILLTOWN RD
BRIDGEWATER NJ
08807-2506
US

IV. Provider business mailing address

499 MILLTOWN RD
BRIDGEWATER NJ
08807-2506
US

V. Phone/Fax

Practice location:
  • Phone: 908-393-1578
  • Fax:
Mailing address:
  • Phone: 908-393-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License Number26NR09673900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: