1326146085 NPI number — CATHERINE MAY REYES P.T.

Table of content: CATHERINE MAY REYES P.T. (NPI 1326146085)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326146085 NPI number — CATHERINE MAY REYES P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REYES
Provider First Name:
CATHERINE
Provider Middle Name:
MAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AFDAL
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
MAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326146085
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
839 58TH ST.
Provider Second Line Business Mailing Address:
BASEMENT
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11220-3679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-686-1736
Provider Business Mailing Address Fax Number:
718-686-7098

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
839 58TH ST.
Provider Second Line Business Practice Location Address:
BASEMENT
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11220-3679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-686-1736
Provider Business Practice Location Address Fax Number:
718-686-7098
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  024408-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 024408 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02544769 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024408-1 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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