Basic Information
Provider Information
NPI: 1285625632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIRIZ
FirstName: TOEYA
MiddleName: RIVERA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX CVPI
Address2:  
City: RICHLANDS
State: VA
PostalCode: 246411100
CountryCode: US
TelephoneNumber: 2769646771
FaxNumber: 2769641376
Practice Location
Address1: ONE CLINIC DRIVE
Address2: CLAYPOOL HILL
City: RICHLANDS
State: VA
PostalCode: 246411100
CountryCode: US
TelephoneNumber: 2769646771
FaxNumber: 2769641376
Other Information
ProviderEnumerationDate: 11/03/2005
LastUpdateDate: 03/09/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101-054122VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
608156805VA MEDICAID
24098301 ANTHEM BCBSOTHER
6400678605KY MEDICAID
11012238801 RAILROAD MEDICAREOTHER
0079237-00005WV MEDICAID


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