Provider Demographics
NPI:1457495582
Name:RIVERA-MASS, ARLENE M (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:M
Last Name:RIVERA-MASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CALLE JILGUERO
Mailing Address - Street 2:URB. MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7109
Mailing Address - Country:US
Mailing Address - Phone:787-731-8196
Mailing Address - Fax:
Practice Address - Street 1:344 CALLE HECTOR SALAMAN
Practice Address - Street 2:URB. EXT. ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2112
Practice Address - Country:US
Practice Address - Phone:787-765-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR120852084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR88698Medicare ID - Type Unspecified