Provider Demographics
NPI:1568028819
Name:REYES, MARITESS ALCOBER (APN-C)
Entity Type:Individual
Prefix:
First Name:MARITESS
Middle Name:ALCOBER
Last Name:REYES
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 N CAROLINA CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-4179
Mailing Address - Country:US
Mailing Address - Phone:732-895-5461
Mailing Address - Fax:
Practice Address - Street 1:25 MULE RD UNIT B8
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5037
Practice Address - Country:US
Practice Address - Phone:732-240-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00857000363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology