Individual
RAYMOND MANUEL RIVERA VERGARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4720 PINE ST APT C3, PHILADELPHIA, PA 19143-1840
(267) 595-1655
(302) 233-7475
Mailing address
4720 PINE ST APT C3, PHILADELPHIA, PA 19143-1840
(267) 595-1655
(302) 233-7475
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
21515
PR
208D00000X
General Practice Physician
Primary
MD478007
PA
Other
Enumeration date
10/07/2015
Last updated
04/07/2023
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