Healthcare Provider Details

I. General information

NPI: 1396812954
Provider Name (Legal Business Name): JOSE FRANCO DOCTOR REYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E MADISON AVE
MAGNOLIA NJ
08049
US

IV. Provider business mailing address

106 HILLSIDE LN
MOUNT LAUREL NJ
08054-4522
US

V. Phone/Fax

Practice location:
  • Phone: 856-361-2720
  • Fax:
Mailing address:
  • Phone: 856-912-8296
  • Fax: 856-885-6258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMA72054
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: