| Rommel Rivera, M.d., P.c. | |
|
110 S 20th St Suite 206 Philadelphia PA 19103-4486 | |
| (610) 892-0565 | |
| Not Available |
| Full Name | Rommel Rivera, M.d., P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 110 S 20th St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Rommel Rivera (OWNER) |
| Authorized Official Contact | 6108920565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rommel Rivera, M.d., P.c. 2084 N Ridley Creek Rd Media PA 19063-4531 Ph: (610) 892-0565 | Rommel Rivera, M.d., P.c. 110 S 20th St Suite 206 Philadelphia PA 19103-4486 Ph: (610) 892-0565 |
| NPI Number | 1760620900 |
|---|---|
| Provider Enumeration Date | 01/26/2009 |
| Last Update Date | 01/26/2009 |
| Medicare PECOS PAC ID | 8224194832 |
|---|---|
| Medicare Enrollment ID | O20090306000060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760620900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD060112L (Pennsylvania) | Primary |
| Provider Name | Rommel Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619098159 PECOS PAC ID: 9335205939 Enrollment ID: I20090306000046 |
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