Provider Demographics
NPI:1003829789
Name:RIVERA CASTRO, ERICKA (MD)
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:RIVERA CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:RIVERA
Other - Last Name:CASTRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:826 AVE MOLUCAS
Mailing Address - Street 2:ITURREGUI
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-769-1571
Mailing Address - Fax:787-257-6180
Practice Address - Street 1:826 AVE MOLUCAS
Practice Address - Street 2:ITURREGUI
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-769-1571
Practice Address - Fax:787-257-6180
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR75262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0098977Medicare PIN
PRD08794Medicare UPIN