Healthcare Provider Details

I. General information

NPI: 1336055888
Provider Name (Legal Business Name): NYDIA EILEEN TORRES RIVERA LCDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150-6 BDA FELIX CORDOVA DAVILA
MANATI PR
00674-5937
US

IV. Provider business mailing address

150-6 BDA FELIX CORDOVA DAVILA
MANATI PR
00674-5937
US

V. Phone/Fax

Practice location:
  • Phone: 939-915-6367
  • Fax:
Mailing address:
  • Phone: 939-915-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number9216
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: