Provider Demographics
NPI:1376563726
Name:DELOS REYES, CHRISTINA M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:DELOS REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0740242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000224259OtherUNISON
OH2189948Medicaid
OH363476OtherWELLCARE MEDICAID
OH7693653OtherAETNA
OH000000532968OtherANTHEM
OH260047459OtherRAILROAD MEDICARE
OHP00972487OtherMEDICARE RAILROAD
OH000000224259OtherUNISON
OHP00972487OtherMEDICARE RAILROAD
OHDE4015284Medicare PIN