Provider Demographics
NPI:1063722114
Name:REYES-RIGOR, ROSARIO H (MD)
Entity type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:H
Last Name:REYES-RIGOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2113
Mailing Address - Country:US
Mailing Address - Phone:718-220-4499
Mailing Address - Fax:718-220-9699
Practice Address - Street 1:60 W KINGSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-7509
Practice Address - Country:US
Practice Address - Phone:718-220-4499
Practice Address - Fax:718-220-9699
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165916208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00951111Medicaid
NY00951111Medicaid