Individual
ODIN DELOS REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
1 POMPERAUG OFFICE PARK, SUITE 105, SOUTHBURY, CT 06488-2295
(203) 262-6100
(203) 264-6679
Mailing address
1 POMPERAUG OFFICE PARK, SUITE 105, SOUTHBURY, CT 06488-2295
(203) 262-6100
(203) 264-6679
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
CT 000 680
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004186947
—
CT
01
—
480026445
RAILROAD MEDICARE PIN
CT
Enumeration date
08/29/2006
Last updated
04/26/2016
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