Provider Demographics
NPI:1336677525
Name:REYES, ALBA
Entity Type:Individual
Prefix:MS
First Name:ALBA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 BROADWAY STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1615
Mailing Address - Country:US
Mailing Address - Phone:212-795-9888
Mailing Address - Fax:212-795-9899
Practice Address - Street 1:5030 BROADWAY STE 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1615
Practice Address - Country:US
Practice Address - Phone:212-795-9888
Practice Address - Fax:212-795-9899
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0931871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty