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NPI Code Detail

MEDICARE: CARLOS D REYES

MEDICARE:   CARLOS D REYES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1063715795
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS D REYES
Provider Business Mailing Address
First Line : 2326 CROSSING WAY
Second Line :
City : WAYNE
State : NJ
Zip : 07470-4733
Country : US
Telephone Number : 201-232-8545
Fax Number :
Provider Business Practice Location Address
First Line : 2326 CROSSING WAY
Second Line :
City : WAYNE
State : NJ
Zip : 07470-4733
Country : US
Telephone Number : 201-232-8545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2010
Last Update Date : 12/20/2010

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Directions to “ CARLOS D REYES ” Practice Location

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