Provider Demographics
NPI:1093232316
Name:RIOS, ALFONSINA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ALFONSINA
Middle Name:
Last Name:RIOS
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2187 HOLLAND AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1765
Mailing Address - Country:US
Mailing Address - Phone:347-612-2014
Mailing Address - Fax:347-612-2014
Practice Address - Street 1:3125 ROUTE 9W STE 204
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6764
Practice Address - Country:US
Practice Address - Phone:347-612-2014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685391-1163W00000X
NYF406631-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse