Individual
JOSE RIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2976 NORTHERN BLVD, LONG ISLAND CITY, NY 11101-2822
(347) 510-3641
Mailing address
45 CHURCH ST APT 7, PATCHOGUE, NY 11772-3548
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02740141
—
NY
Enumeration date
07/24/2008
Last updated
07/24/2008
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