Healthcare Provider Details

I. General information

NPI: 1922345768
Provider Name (Legal Business Name): 181ST STREET MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 W 181ST ST
NEW YORK NY
10033-5102
US

IV. Provider business mailing address

521 W 181ST ST
NEW YORK NY
10033-5102
US

V. Phone/Fax

Practice location:
  • Phone: 347-756-6000
  • Fax: 646-682-9797
Mailing address:
  • Phone: 347-756-0000
  • Fax: 646-682-9797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HECTOR DARIO REYES
Title or Position: ADMINISTARTOR
Credential: MBA
Phone: 917-771-9827