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General NPI Number Information
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NPI Number | 1740509470
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Entity Type | Individual
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Provider Name | NISHA L. RIVERA NEGRON LCDA
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Gender | Female
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 20 CALLE RUFINA SUITE 2 BAJOS
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City | GUAYANILLA
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State | PR
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Zip | 00656
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Country | US
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Telephone | 787-209-4146
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Fax |
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Provider Business Mailing Address
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Address Line | 11182 MARGARITA STREET URB. HACIENDA CONCORDIA
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-209-4146
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 1528
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License Number State | PR
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