Provider Demographics
NPI:1508945775
Name:REYES, VICTOR C (DPT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:C
Last Name:REYES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:755 NEW YORK AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-351-7676
Mailing Address - Fax:631-351-7667
Practice Address - Street 1:755 NEW YORK AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-351-7676
Practice Address - Fax:631-351-7667
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY027462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WFH1Medicare PIN