Healthcare Provider Details
I. General information
NPI: 1124342878
Provider Name (Legal Business Name): JENNIFER MARGARET RECKREY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/24/2010
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 E 41ST ST FL 18
NEW YORK NY
10017-6739
US
IV. Provider business mailing address
222 E 41ST ST FL 18
NEW YORK NY
10017-6739
US
V. Phone/Fax
- Phone: 212-263-8313
- Fax: 212-263-8995
- Phone: 212-263-8313
- Fax: 212-263-8995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 255228 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | 255228 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: