Provider Demographics
NPI:1578354684
Name:VAZQUEZ RIVERA, JEAN PAUL (OTD)
Entity type:Individual
Prefix:DR
First Name:JEAN PAUL
Middle Name:
Last Name:VAZQUEZ RIVERA
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD
Mailing Address - Street 1:648 WASHINGTON ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5776
Mailing Address - Country:US
Mailing Address - Phone:774-208-8178
Mailing Address - Fax:
Practice Address - Street 1:648 WASHINGTON ST APT 4
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5776
Practice Address - Country:US
Practice Address - Phone:774-208-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist