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General NPI Number Information
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NPI Number | 1891416384
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Entity Type | Organization
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Legal Business Name | JOHN A REYES MD PC
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 15A BERRY HILL RD
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City | OYSTER BAY
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State | NY
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Zip | 11771-3538
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Country | US
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Telephone | 516-458-6316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 690
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City | OYSTER BAY
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State | NY
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Zip | 11771-0690
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Country | US
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Telephone | 516-458-6316
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Fax | 631-581-0672
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN A REYES
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Credential | MD
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Telephone | 516-458-6316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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