Individual
HECTOR COLON-RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, MD
Contact information
Practice address
4301 RISING SUN AVE, PHILADELPHIA, PA 19140-2719
(267) 296-7220
(203) 781-4624
Mailing address
4301 RISING SUN AVE, PHILADELPHIA, PA 19140-2719
(267) 296-7220
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
MD460473
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
008022626
—
CT
05
—
008056168
—
CT
01
—
008066315
COLON RIVERA MEDICAID
CT
05
—
103409158
—
PA
05
—
500000315
—
CT
Enumeration date
03/28/2012
Last updated
01/26/2023
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