Healthcare Provider Details

I. General information

NPI: 1669686788
Provider Name (Legal Business Name): DANIEL ALFREDO PAPPATERRA M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE RAFAEL ARROYO RIOS # 7 SUR
HUMACAO PR
00791
US

IV. Provider business mailing address

214 CALLE CORNELL UNIVERSITY GARDENS
SAN JUAN PR
00927-4123
US

V. Phone/Fax

Practice location:
  • Phone: 787-850-1695
  • Fax:
Mailing address:
  • Phone: 787-536-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1575
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: