Provider Demographics
NPI:1457641300
Name:REED, DOUGLAS ARVELL (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:ARVELL
Last Name:REED
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:DOUGLAS
Other - Middle Name:
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C, PMHNP-BC
Mailing Address - Street 1:1434 WILLIAMSBRIDGE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2507
Mailing Address - Country:US
Mailing Address - Phone:718-618-0401
Mailing Address - Fax:347-479-1303
Practice Address - Street 1:2015 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4303
Practice Address - Country:US
Practice Address - Phone:718-299-7295
Practice Address - Fax:718-299-6797
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402146363LP0808X
NY402146363LP0808X
DCRN1008625363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health