Individual
TATIANA REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
526 FASHION AVE FL 3, NEW YORK, NY 10018-4833
(212) 221-3691
Mailing address
2800 HEATH AVE APT 6L, BRONX, NY 10463-7835
(347) 376-2603
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
032392
NY
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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