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Individual

ROMMEL LUBIANO RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
110 S 20TH ST, SUITE 206, PHILADELPHIA, PA 19103-4486
(610) 892-0565
Mailing address
2084 N RIDLEY CREEK RD, MEDIA, PA 19063-4531
(610) 892-0565

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD 060112L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1753482
PA
Enumeration date
04/03/2007
Last updated
07/09/2007
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