Provider Demographics
NPI:1629049580
Name:ALTIERI, ANIBELLE
Entity Type:Individual
Prefix:
First Name:ANIBELLE
Middle Name:
Last Name:ALTIERI
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:PO BOX 195676
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5676
Mailing Address - Country:US
Mailing Address - Phone:787-758-0271
Mailing Address - Fax:
Practice Address - Street 1:CALLE ONEILL 197 SEGUNDO PISO
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-0271
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC84175Medicare UPIN
PR97848Medicare ID - Type Unspecified