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General NPI Number Information
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NPI Number | 1629273867
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Entity Type | Individual
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Provider Name | JESSICA C RIVERA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 1542 TULANE AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2865
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Country | US
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Telephone | 504-568-4680
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Fax |
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Provider Business Mailing Address
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Address Line | 203 FOREST OAKS DR
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City | NEW ORLEANS
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State | LA
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Zip | 70131-3377
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Country | US
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Telephone | 210-232-1514
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 44329
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 321514
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License Number State | LA
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