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NPI Code Detail

MEDICARE: MARLENE REYNOLDS M.S.ED

MEDICARE: MARLENE REYNOLDS M.S.ED
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
1251B00000XCase Management Agency
2252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1336401827
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE REYNOLDS M.S.ED
Provider Business Mailing Address
First Line : 425 PENNSYLVANIA AVE
Second Line : PO BOX 588
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-737-5566
Fax Number : 607-737-5480
Provider Business Practice Location Address
First Line : 425 PENNSYLVANIA AVE
Second Line :
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-737-5566
Fax Number : 607-737-5480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2012
Last Update Date : 05/24/2013

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Directions to “ MARLENE REYNOLDS M.S.ED” Practice Location

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