Individual
MR. RODNEY SAM REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, ADV. CASAC-G
Contact information
Practice address
770 E 176TH ST, BRONX, NY 10460-4617
(929) 306-7951
Mailing address
770 ST 176, 630 CONCORD AVENUE, BRONX, NY 10455-1045
(929) 306-7951
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
28646
NY
Other
Enumeration date
04/09/2015
Last updated
10/22/2024
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