Provider Demographics
NPI:1093183329
Name:PLEITEZ, REYNA (MSED)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:
Last Name:PLEITEZ
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14750 72ND DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2536
Mailing Address - Country:US
Mailing Address - Phone:201-622-8538
Mailing Address - Fax:
Practice Address - Street 1:7125 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2014
Practice Address - Country:US
Practice Address - Phone:718-261-0211
Practice Address - Fax:718-268-0556
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool