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NPI Code Detail

MEDICARE: YOHANNA A REYES PA-C

MEDICARE: YOHANNA A REYES PA-C
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
1363A00000XPhysician Assistant011172NY

General Provider Information

NPI Number : 1770511875
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOHANNA A REYES PA-C
Provider Business Mailing Address
First Line : 1 RESEARCH RD
Second Line :
City : RIDGE
State : NY
Zip : 11961-2701
Country : US
Telephone Number : 631-751-3000
Fax Number :
Provider Business Practice Location Address
First Line : 1377 5TH AVE
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-4131
Country : US
Telephone Number : 631-751-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 03/21/2023

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Directions to “ YOHANNA A REYES PA-C” Practice Location

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