Provider Demographics
NPI:1336517697
Name:GUY, ELLA-CECILIA REYES (NP)
Entity Type:Individual
Prefix:
First Name:ELLA-CECILIA
Middle Name:REYES
Last Name:GUY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 OLD SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6124
Mailing Address - Country:US
Mailing Address - Phone:914-391-6973
Mailing Address - Fax:
Practice Address - Street 1:29 OLD SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6124
Practice Address - Country:US
Practice Address - Phone:914-391-6973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF307430-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health