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General NPI Number Information
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NPI Number | 1932865516
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Entity Type | Individual
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Provider Name | JOSE ALBERTO RIVERA-SANTIAGO MT
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Gender | Male
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1255 HILLRISE CIR
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City | LAS CRUCES
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State | NM
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Zip | 88011-4741
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Country | US
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Telephone | 575-532-5934
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Fax | 575-522-9047
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Provider Business Mailing Address
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Address Line | 1255 HILLRISE CIR
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City | LAS CRUCES
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State | NM
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Zip | 88011-4741
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Country | US
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Telephone | 575-532-5934
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Fax | 575-522-9047
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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 | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number | 196865
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License Number State | NM
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