Provider Demographics
NPI:1871232637
Name:ARIAS, ROXANA DORIS (MSN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:DORIS
Last Name:ARIAS
Suffix:
Gender:F
Credentials:MSN,FNP-BC
Other - Prefix:
Other - First Name:ROXANA
Other - Middle Name:DORIS
Other - Last Name:CORDERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12 OAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-1403
Mailing Address - Country:US
Mailing Address - Phone:646-243-7394
Mailing Address - Fax:
Practice Address - Street 1:575 W 181ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5002
Practice Address - Country:US
Practice Address - Phone:212-342-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347887-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily