Individual
WARDALINA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 W 188TH ST, NEW YORK, NY 10040-4617
(646) 322-3074
Mailing address
504 W 188TH ST, NEW YORK, NY 10040-4617
(646) 322-3074
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
692695
NY
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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