MEDICARE: JOSHUA ABRAHAM RIVERA-TORRES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	0098741	NM

General Provider Information

NPI Number	:	1932071057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ABRAHAM RIVERA-TORRES

Provider Business Mailing Address
First Line	:	3240 JUAN TABO BLVD NE BLDG A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-5187
Country	:	US
Telephone Number	:	505-705-0571
Fax Number	:	505-503-1617

Provider Business Practice Location Address
First Line	:	3240 JUAN TABO BLVD NE BLDG A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-5187
Country	:	US
Telephone Number	:	505-705-0571
Fax Number	:	505-503-1617

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	09/18/2025

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