Provider Demographics
NPI:1235792151
Name:ESCALERA RIVERA, SENIA M
Entity Type:Individual
Prefix:MRS
First Name:SENIA
Middle Name:M
Last Name:ESCALERA RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SENIA
Other - Middle Name:M
Other - Last Name:ESCALERA RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:INDEPENDENT PROVIDER
Mailing Address - Street 1:833 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1525
Mailing Address - Country:US
Mailing Address - Phone:484-626-6275
Mailing Address - Fax:
Practice Address - Street 1:833 MERCER ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1525
Practice Address - Country:US
Practice Address - Phone:484-626-6275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171R00000X, 372500000X, 372600000X, 374T00000X, 376J00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325916Medicaid