Provider Demographics
NPI:1447013057
Name:IRONS, RIA (LPN, CHW)
Entity type:Individual
Prefix:
First Name:RIA
Middle Name:
Last Name:IRONS
Suffix:
Gender:F
Credentials:LPN, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N MAIN ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1047
Mailing Address - Country:US
Mailing Address - Phone:032-517-7940
Mailing Address - Fax:
Practice Address - Street 1:31 N MAIN ST UNIT 2
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1047
Practice Address - Country:US
Practice Address - Phone:032-517-7940
Practice Address - Fax:888-880-7706
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT475172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker