Provider Demographics
NPI:1346588332
Name:RIOS, IVETH ESTHER (MA)
Entity Type:Individual
Prefix:MRS
First Name:IVETH
Middle Name:ESTHER
Last Name:RIOS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 49TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1803
Mailing Address - Country:US
Mailing Address - Phone:917-496-5881
Mailing Address - Fax:
Practice Address - Street 1:353 49TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1803
Practice Address - Country:US
Practice Address - Phone:917-496-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist