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General NPI Number Information
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NPI Number | 1861676884
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Entity Type | Organization
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Legal Business Name | DR. JEROME E. REEVES, DPM, PLLC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 205-07 HILLSIDE AVENUE SUITE 15
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City | HOLLIS
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State | NY
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Zip | 11423
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Country | US
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Telephone | 718-479-5747
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Fax |
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Provider Business Mailing Address
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Address Line | 8451 BEVERLY RD 2T
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City | KEW GARDENS
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State | NY
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Zip | 11415-2123
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Country | US
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Telephone | 718-441-6271
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Fax |
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Authorized Official
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Title or Position | PODIATRIC PHYSICIAN
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Name | DR. JEROME E. REEVES
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Credential | D.P.M.
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Telephone | 718-479-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | N005132
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License Number State | NY
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