Provider Demographics
NPI:1356560189
Name:TUA, ADA NYDIA (MA)
Entity type:Individual
Prefix:MISS
First Name:ADA
Middle Name:NYDIA
Last Name:TUA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE DUARTE
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-1133
Mailing Address - Country:US
Mailing Address - Phone:787-832-1148
Mailing Address - Fax:787-265-5583
Practice Address - Street 1:104 CALLE RELAMPAGO
Practice Address - Street 2:EDIF. CENTRO DEL OESTE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-0000
Practice Address - Country:US
Practice Address - Phone:787-458-2794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1585103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1574OtherAPS HUMANA
PR1050397OtherCIGNA