Provider Demographics
NPI:1710684188
Name:OBENZA, RIEGAR Y (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:RIEGAR
Middle Name:Y
Last Name:OBENZA
Suffix:
Gender:M
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:OBENZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NBC-HWC
Mailing Address - Street 1:UNIVERSITY DRIVE C
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240-1003
Mailing Address - Country:US
Mailing Address - Phone:412-360-6000
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE C
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1003
Practice Address - Country:US
Practice Address - Phone:412-360-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3532458171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach