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General NPI Number Information
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NPI Number | 1568034783
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Entity Type | Individual
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Provider Name | DIANA RIVERA PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 11590 CENTURY BLVD STE 102
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City | CINCINNATI
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State | OH
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Zip | 45246-3317
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Country | US
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Telephone | 513-648-9077
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Fax | 513-648-9554
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Provider Business Mailing Address
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Address Line | PO BOX 636256
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City | CINCINNATI
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State | OH
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Zip | 45263-6256
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Country | US
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Telephone | 513-585-6200
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Fax | 513-245-3672
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.008477RX
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License Number State | OH
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