Healthcare Provider Details

I. General information

NPI: 1376725739
Provider Name (Legal Business Name): INES A. RIERA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INES A. ABAD-MANTEROLA

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 BROAD ST
PROVIDENCE RI
02903-4026
US

IV. Provider business mailing address

345 WHITNEY AVENUE
NEW HAVEN CT
06511-2348
US

V. Phone/Fax

Practice location:
  • Phone: 513-653-0904
  • Fax:
Mailing address:
  • Phone: 203-752-2856
  • Fax: 203-752-8785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number004360
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0004360
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN80412
License Number StateRI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number550423
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN04532
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number420871-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: