Provider Demographics
NPI:1275318727
Name:RIOS, JOSEPHINE SORIANO (COTA)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:SORIANO
Last Name:RIOS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 BEACH BREEZE LN
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-2007
Mailing Address - Country:US
Mailing Address - Phone:347-524-0037
Mailing Address - Fax:
Practice Address - Street 1:257 BEACH BREEZE LN
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-2007
Practice Address - Country:US
Practice Address - Phone:347-524-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003379224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant