Provider Demographics
NPI:1801090261
Name:ABREU RIVERA, ARLENE MARIA (MD)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARIA
Last Name:ABREU RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:MARIA
Other - Last Name:RIVERA ( OR ABREU - USED BOTH)
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-6184
Mailing Address - Country:US
Mailing Address - Phone:787-653-3434
Mailing Address - Fax:
Practice Address - Street 1:100 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6184
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10875174400000X, 207R00000X
NY196538208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400004939Medicare PIN
PRF86336Medicare UPIN