MEDICARE: MRS. MICHELLE 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
1	163W00000X	Registered Nurse	690217	NY

General Provider Information

NPI Number	:	1295131068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE REYES

Provider Business Mailing Address
First Line	:	425 E 25TH ST
Second Line	:	BOX 696
City	:	NEW YORK
State	:	NY
Zip	:	10010-2547
Country	:	US
Telephone Number	:	646-915-5714
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 E 25TH ST
Second Line	:	BOX 696
City	:	NEW YORK
State	:	NY
Zip	:	10010-2547
Country	:	US
Telephone Number	:	646-915-5714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	11/06/2014

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Directions to “ MRS. MICHELLE REYES ” Practice Location

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