Provider Demographics
NPI:1376725739
Name:RIERA, INES A (APRN)
Entity Type:Individual
Prefix:MRS
First Name:INES
Middle Name:A
Last Name:RIERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:INES
Other - Middle Name:A
Other - Last Name:ABAD-MANTEROLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:345 WHITNEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2348
Mailing Address - Country:US
Mailing Address - Phone:203-752-2856
Mailing Address - Fax:203-752-8785
Practice Address - Street 1:211 STATE STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4808
Practice Address - Country:US
Practice Address - Phone:203-366-0664
Practice Address - Fax:203-752-2856
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550423163W00000X
CT004360363LW0102X
NY420871-1363LW0102X
CT0004360363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse