Organization
DYCKMAN MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELTON REYES MD (OWNER)
(347) 963-4835
Entity
Organization
Contact information
Practice address
271 E 198TH ST, GROUND FLOOR, BRONX, NY 10458-3170
(347) 963-4835
(718) 220-4739
Mailing address
271 E 198TH ST, GROUND FLOOR, BRONX, NY 10458-3170
(347) 963-4835
(718) 220-4739
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
207304
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01863529
—
NY
Enumeration date
02/03/2016
Last updated
02/03/2016
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