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General NPI Number Information
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NPI Number | 1801917133
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Entity Type | Individual
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Provider Name | MERCEDITA QUIROS RIVERA MD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 65 BROADWAY
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City | NEWARK
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State | NJ
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Zip | 07104
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Country | US
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Telephone | 973-483-6110
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Fax | 973-483-6110
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Provider Business Mailing Address
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Address Line | 75 BEVERLY ROAD
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City | WEST CALDWELL
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State | NJ
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Zip | 07006
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Country | US
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Telephone | 973-228-6876
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA03870900
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License Number State | NJ
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