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General NPI Number Information
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NPI Number | 1174981799
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Entity Type | Individual
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Provider Name | DUMAR RIVERA-HERRERA APN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/16/2019
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Provider Practice Location Address
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Address Line | 25 ACADEMY ST
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City | DOVER
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State | NJ
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Zip | 07801-4905
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Country | US
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Telephone | 862-812-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 25 ACADEMY ST
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City | DOVER
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State | NJ
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Zip | 07801-4905
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Country | US
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Telephone | 862-812-9020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR14881000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26NJ00629400
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License Number State | NJ
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