Provider Demographics
NPI:1932208873
Name:DR. ROSARIO H. REYES-RIGOR PHYSICIAN PC
Entity type:Organization
Organization Name:DR. ROSARIO H. REYES-RIGOR PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:H
Authorized Official - Last Name:REYES-RIGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-843-5805
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:914-843-5805
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165916208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00951111Medicaid
NY03457921OtherMEDICAID PROVIDER NUMBER GROUP
NY72D271Medicare ID - Type Unspecified
NYA63989Medicare UPIN