Organization
CCN GENERAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR D REYES MBA (ADM)
(718) 569-7929
Entity
Organization
Contact information
Practice address
1262 BOSTON RD, SUITE 2, BRONX, NY 10456-3602
(718) 569-7929
(347) 590-5482
Mailing address
1262 BOSTON RD, SUITE 2, BRONX, NY 10456-3602
(718) 569-7929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
255626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02932589
—
NY
01
—
1427118140
NPI
NY
Enumeration date
03/18/2010
Last updated
03/23/2026
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