Healthcare Provider Details

I. General information

NPI: 1063722114
Provider Name (Legal Business Name): ROSARIO H REYES-RIGOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W KINGSBRIDGE RD
BRONX NY
10468-7509
US

IV. Provider business mailing address

7 SPRING RD
VALLEY COTTAGE NY
10989-2113
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-4499
  • Fax: 718-220-9699
Mailing address:
  • Phone: 718-220-4499
  • Fax: 718-220-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number165916
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: