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NPI Code Detail

MEDICARE: MR. EUGENE RYAN REYES LANDINGIN PT

MEDICARE: MR. EUGENE RYAN REYES LANDINGIN PT
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
1225100000XPhysical Therapist070017123IL
2225100000XPhysical Therapist9701978NY
3225100000XPhysical Therapist40QA01371300NJ
4225100000XPhysical Therapist008642CT

General Provider Information

NPI Number : 1942539267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EUGENE RYAN REYES LANDINGIN PT
Provider Business Mailing Address
First Line : 1616 HAMILTON ST
Second Line :
City : BELLEVILLE
State : NJ
Zip : 07109-5346
Country : US
Telephone Number : 630-398-1430
Fax Number : 205-520-0455
Provider Business Practice Location Address
First Line : 1616 HAMILTON ST
Second Line :
City : BELLEVILLE
State : NJ
Zip : 07109-5346
Country : US
Telephone Number : 630-398-1430
Fax Number : 205-520-0455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2009
Last Update Date : 01/07/2019

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