Individual
NICOLAS B RIVERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4000
Mailing address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP10023252
TX
2080P0203X
Pediatric Critical Care Medicine Physician
13782
NV
2080P0203X
Pediatric Critical Care Medicine Physician
2012-00180
NC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35099353
OH
2080P0203X
Pediatric Critical Care Medicine Physician
7209
SD
2080P0203X
Pediatric Critical Care Medicine Physician
N8840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609044296
TRICARE
—
05
—
1609044296
—
MN
05
—
1609044296
—
SD
Enumeration date
02/15/2008
Last updated
11/03/2023
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