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NPI Code Detail

MEDICARE: NANCY REYES A.P.N.-C

MEDICARE: NANCY REYES A.P.N.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner26NJ00063300NJ

General Provider Information

NPI Number : 1134170673
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY REYES A.P.N.-C
Provider Business Mailing Address
First Line : 220 JACKSON AVE
Second Line :
City : ROCKAWAY
State : NJ
Zip : 07866-1018
Country : US
Telephone Number : 973-586-2941
Fax Number : 201-536-9047
Provider Business Practice Location Address
First Line : 196 JEWETT AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07304-1804
Country : US
Telephone Number : 201-536-9000
Fax Number : 201-536-9047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/08/2007

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