Individual
GUILLERMO YSMAEL REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 W BURNSIDE AVE, BRONX, NY 10453-4018
(718) 299-5454
(718) 299-0770
Mailing address
47 VAN BUREN AVE, TEANECK, NJ 07666-4142
(201) 530-0261
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
01812019
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01812019
—
NY
Enumeration date
11/30/2006
Last updated
07/08/2007
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