MEDICARE: DR. JOSE FRANCO DOCTOR REYES M.D.

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
1	2084P0800X	Psychiatry Physician	MA72054	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	054996C2B	OTHER	NJ	MEDICARE BILLING NO.

General Provider Information

NPI Number	:	1396812954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE FRANCO DOCTOR REYES M.D.

Provider Business Mailing Address
First Line	:	106 HILLSIDE LN
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-4522
Country	:	US
Telephone Number	:	856-912-8296
Fax Number	:	856-885-6258

Provider Business Practice Location Address
First Line	:	212 E MADISON AVE
Second Line	:
City	:	MAGNOLIA
State	:	NJ
Zip	:	08049
Country	:	US
Telephone Number	:	856-361-2720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	08/13/2025

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