Individual
MISS ANTONIETTA DE LOS REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1361 HYLAN BLVD, STATEN ISLAND, NY 10305-1902
(718) 979-2828
Mailing address
10752 93RD ST, OZONE PARK, NY 11417-1507
(646) 220-9055
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F334883
NY
363LF0000X
Family Nurse Practitioner
26NJ00169800
NJ
Other
Enumeration date
09/20/2006
Last updated
06/05/2009
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