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General NPI Number Information
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NPI Number | 1932109162
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Entity Type | Individual
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Provider Name | ELIZABETH REYNOLDS MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | BARTON ASSOCIATES 300 JUBILEE DRIVE
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City | PEABODY
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State | MA
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Zip | 01960-2508
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Country | US
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Telephone | 860-249-9625
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Fax | 860-808-1536
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Provider Business Mailing Address
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Address Line | PO BOX 529
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City | YONKERS
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State | NY
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Zip | 10710-0529
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Country | US
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Telephone | 347-454-1759
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 52148
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 211539
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License Number State | NY
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