Provider Demographics
NPI:1053755413
Name:RIVERA, CATHERINE M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 813
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-0813
Mailing Address - Country:US
Mailing Address - Phone:787-619-0566
Mailing Address - Fax:
Practice Address - Street 1:70 AVE RIO HONDO
Practice Address - Street 2:WALGREENS #11430
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3157
Practice Address - Country:US
Practice Address - Phone:787-619-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist