Provider Demographics
NPI:1376230227
Name:VEGA, ADRIANA BEATRIZ
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:BEATRIZ
Last Name:VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DF8 CALLE PRADERAS
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3347
Mailing Address - Country:US
Mailing Address - Phone:787-685-5387
Mailing Address - Fax:
Practice Address - Street 1:890 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3978
Practice Address - Country:US
Practice Address - Phone:718-991-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program