Individual
LYDIA LIZ FUENTES RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8268 164TH ST BLDG 7TH, JAMAICA, NY 11432-1121
(718) 883-3000
Mailing address
7842 73RD PL, GLENDALE, NY 11385-7426
(787) 363-6914
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22193
PR
207RN0300X
Nephrology Physician
157982
FL
207RN0300X
Nephrology Physician
Primary
325936
NY
208D00000X
General Practice Physician
22193
PR
390200000X
Student in an Organized Health Care Education/Training Program
33454
PR
390200000X
Student in an Organized Health Care Education/Training Program
34120
PR
390200000X
Student in an Organized Health Care Education/Training Program
35007
PR
Other
Enumeration date
07/09/2018
Last updated
11/03/2023
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