Provider Demographics
NPI:1285038844
Name:RIVERA, MARTA NEOLANY (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:NEOLANY
Last Name:RIVERA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#ZB-1A STREET 21
Mailing Address - Street 2:REXVILLE
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-508-3413
Mailing Address - Fax:
Practice Address - Street 1:#ZB-1A STREET 21
Practice Address - Street 2:REXVILLE
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-508-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR709152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist