Provider Demographics
NPI:1962657502
Name:RIOS, RUTH ELIANE (OTR)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ELIANE
Last Name:RIOS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TOTTENHAM PL
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3517
Mailing Address - Country:US
Mailing Address - Phone:516-294-4468
Mailing Address - Fax:
Practice Address - Street 1:22 TOTTENHAM PL
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3517
Practice Address - Country:US
Practice Address - Phone:516-294-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003012-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist