Provider Demographics
NPI:1235167123
Name:RIVERA, LOYDA I (MD, FAAP, FACC)
Entity Type:Individual
Prefix:
First Name:LOYDA
Middle Name:I
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD, FAAP, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 ALLAIRE RD
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9165
Mailing Address - Country:US
Mailing Address - Phone:732-282-1060
Mailing Address - Fax:732-282-1061
Practice Address - Street 1:3204 ALLAIRE RD
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9165
Practice Address - Country:US
Practice Address - Phone:732-282-1060
Practice Address - Fax:732-282-1061
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0543502080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology