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General NPI Number Information
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NPI Number | 1225619836
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Entity Type | Individual
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Provider Name | CYNTHIA COLON-RIVERA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 489 STATE ST
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City | BANGOR
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State | ME
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Zip | 04401-6616
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Country | US
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Telephone | 207-992-4133
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Fax |
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Provider Business Mailing Address
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Address Line | 119 LOWER DEDHAM RD
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City | HOLDEN
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State | ME
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Zip | 04429-7506
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Country | US
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Telephone | 312-391-9171
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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 | RN78163
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License Number State | ME
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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 | RNA213044
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License Number State | ME
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