Provider Demographics
NPI:1841037900
Name:RIOS, ZACHARY (MSN, APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:RIOS
Suffix:
Gender:M
Credentials:MSN, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HARMONY CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5637
Mailing Address - Country:US
Mailing Address - Phone:732-966-2503
Mailing Address - Fax:
Practice Address - Street 1:103 OLD MARLTON PIKE STE 124
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:732-966-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15098900363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care