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General NPI Number Information
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NPI Number | 1942539267
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Entity Type | Individual
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Provider Name | EUGENE RYAN REYES LANDINGIN PT
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Gender | Male
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 1616 HAMILTON ST
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City | BELLEVILLE
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State | NJ
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Zip | 07109-5346
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Country | US
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Telephone | 630-398-1430
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Fax | 205-520-0455
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Provider Business Mailing Address
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Address Line | 1616 HAMILTON ST
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City | BELLEVILLE
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State | NJ
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Zip | 07109-5346
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Country | US
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Telephone | 630-398-1430
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Fax | 205-520-0455
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070017123
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9701978
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01371300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008642
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License Number State | CT
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