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General NPI Number Information
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NPI Number | 1124987334
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Entity Type | Organization
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Legal Business Name | AUGUSTO REYNOSO LLC
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 414 E 41ST ST
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City | PATERSON
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State | NJ
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Zip | 07504-1221
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Country | US
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Telephone | 201-564-0390
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Fax |
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Provider Business Mailing Address
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Address Line | 414 E 41ST ST
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City | PATERSON
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State | NJ
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Zip | 07504-1221
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AUGUSTO REYNOSO
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Credential | PT, DPT, ATC
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Telephone | 973-337-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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