Healthcare Provider Details

I. General information

NPI: 1184585093
Provider Name (Legal Business Name): ABIGAIL REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8041 CYPRESS AVE
GLENDALE NY
11385-6714
US

IV. Provider business mailing address

8041 CYPRESS AVE
GLENDALE NY
11385-6714
US

V. Phone/Fax

Practice location:
  • Phone: 347-935-5110
  • Fax:
Mailing address:
  • Phone: 347-935-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number125367
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: