Healthcare Provider Details

I. General information

NPI: 1578474854
Provider Name (Legal Business Name): JULIA RIOS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ESSEX ST STE 109
HACKENSACK NJ
07601-5417
US

IV. Provider business mailing address

2-14 CYRIL AVE
FAIR LAWN NJ
07410-2003
US

V. Phone/Fax

Practice location:
  • Phone: 551-377-3936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07548600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: