Provider Demographics
NPI:1205047008
Name:NORIEGA, LENNIS (PHT)
Entity type:Individual
Prefix:MS
First Name:LENNIS
Middle Name:
Last Name:NORIEGA
Suffix:
Gender:F
Credentials:PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192735
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2735
Mailing Address - Country:US
Mailing Address - Phone:787-688-0709
Mailing Address - Fax:
Practice Address - Street 1:8TH FLOOR CARDIOVASCULAR CENTER
Practice Address - Street 2:MEDICAL CENTER
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-759-9595
Practice Address - Fax:787-767-4798
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2507183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician