Organization
ODIN DE LOS REYES DPM INC
Active
Organization
ODIN DE LOS REYES DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODIN ANTHONY DE LOS REYES DPM (PODIATRIST)
(203) 262-6100
Entity
Organization
Contact information
Practice address
1 POMPERAUG OFFICE PARK, SUITE 105, SOUTHBURY, CT 06488-2295
(230) 262-6100
(203) 264-6679
Mailing address
1 POMPERAUG OFFICE PARK, SUITE 105, SOUTHBURY, CT 06488-2295
(230) 262-6100
(203) 264-6679
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
CT000680
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004186947
—
CT
Enumeration date
04/13/2007
Last updated
09/23/2020
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