Provider Demographics
NPI:1326370016
Name:REYES, MARLEEN F (RN)
Entity Type:Individual
Prefix:MISS
First Name:MARLEEN
Middle Name:F
Last Name:REYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927-1034
Mailing Address - Country:US
Mailing Address - Phone:845-429-0452
Mailing Address - Fax:
Practice Address - Street 1:163 COOLIDGE ST
Practice Address - Street 2:
Practice Address - City:HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10927-1034
Practice Address - Country:US
Practice Address - Phone:845-429-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY462085-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse