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NPI Code Detail

MEDICARE: DR. JONATHAN VINCENT M REYES MD

MEDICARE: DR. JONATHAN VINCENT M 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
1207RG0100XGastroenterology Physician320180NY

General Provider Information

NPI Number : 1568921351
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN VINCENT M REYES MD
Provider Business Mailing Address
First Line : 57 SCHMIDTS LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5522
Country : US
Telephone Number : 646-385-2697
Fax Number :
Provider Business Practice Location Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number : 516-992-5626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2019
Last Update Date : 03/06/2026

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