Individual
THERESA REYES CUSTODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 PIER POINTE ST, APT 517, YONKERS, NY 10701-6941
(774) 888-7724
Mailing address
1 PIER POINTE ST, APT 517, YONKERS, NY 10701-3569
(774) 888-7724
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
608387-1
NY
163WP0200X
Pediatric Registered Nurse
Primary
608387-1
NY
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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