Individual
SEAN RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5757 HARPER DR NE, ALBUQUERQUE, NM 87109-3566
(505) 888-5757
(505) 875-0160
Mailing address
8801 HORIZON BLVD NE STE 360, ALBUQUERQUE, NM 87113-1563
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD2016-0247
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27772519
—
NM
01
—
2T1762
MEDICARE PTAN
NM
Enumeration date
03/28/2012
Last updated
10/22/2024
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