Individual
ELSA S. REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21008 NORTHERN BLVD, 1ST FLOOR SUITE 3, BAYSIDE, NY 11361-3211
(718) 795-2717
(718) 795-2743
Mailing address
21008 NORTHERN BLVD, 1ST FLOOR SUITE 3, BAYSIDE, NY 11361
(718) 795-2717
(718) 795-2743
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
259126
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02528265
—
NY
Enumeration date
09/07/2006
Last updated
05/19/2025
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