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NPI Code Detail

MEDICARE: LENISSE REYES REYES MD

MEDICARE: LENISSE REYES REYES MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538832118
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENISSE REYES REYES MD
Provider Business Mailing Address
First Line : 515 W 59TH ST APT 31J
Second Line :
City : NEW YORK
State : NY
Zip : 10019-1031
Country : US
Telephone Number : 212-523-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1000 10TH AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10019-1147
Country : US
Telephone Number : 212-523-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2021
Last Update Date : 07/29/2021

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