Healthcare Provider Details

I. General information

NPI: 1922936178
Provider Name (Legal Business Name): RIOS ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E TAUNTON RD STE 559
BERLIN NJ
08009-2615
US

IV. Provider business mailing address

108 HARMONY CIRCLE RD
SICKLERVILLE NJ
08081-5637
US

V. Phone/Fax

Practice location:
  • Phone: 732-966-2503
  • Fax:
Mailing address:
  • Phone: 732-966-2503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY J RIOS
Title or Position: OWNER
Credential: MSN, APRN, AGNP-C
Phone: 732-966-2503