Provider Demographics
NPI:1780185785
Name:MARTINEZ RIVAS, NIURKA
Entity Type:Individual
Prefix:
First Name:NIURKA
Middle Name:
Last Name:MARTINEZ RIVAS
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 1:5130 S PECOS RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1248
Mailing Address - Country:US
Mailing Address - Phone:702-742-8235
Mailing Address - Fax:702-405-8951
Practice Address - Street 1:417 FOXVALE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-6150
Practice Address - Country:US
Practice Address - Phone:102-463-0082
Practice Address - Fax:702-643-1552
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant