Individual
ROBERT REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 TITUS PL, WALTON, NY 13856-1457
(607) 865-2100
(607) 785-2584
Mailing address
1 TITUS PL, WALTON, NY 13856-1457
(607) 865-2100
(607) 785-2584
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
008363
NY
363AM0700X
Medical Physician Assistant
Primary
008363
NY
Other
Enumeration date
11/09/2005
Last updated
12/15/2016
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