Healthcare Provider Details

I. General information

NPI: 1801783121
Provider Name (Legal Business Name): TERRANCE REED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 W F ST APT 1
MC COOK NE
69001-2950
US

IV. Provider business mailing address

1307 W F ST APT 1
MC COOK NE
69001-2950
US

V. Phone/Fax

Practice location:
  • Phone: 201-598-7538
  • Fax:
Mailing address:
  • Phone: 201-598-7538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: