Provider Demographics
NPI:1083753529
Name:NIEVES, DORIS (DPT)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BDAACH/549TH HC
Mailing Address - Street 2:USAG HUMPHREYS, BLDG. #3030 UNIT 15245
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96271
Mailing Address - Country:US
Mailing Address - Phone:011-822-7917
Mailing Address - Fax:
Practice Address - Street 1:BDAACH/549TH HC USAG HUMPHREYS BLDG. #3030
Practice Address - Street 2:UNIT #15245
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96271
Practice Address - Country:US
Practice Address - Phone:011-822-7917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009822225100000X
NY029093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist