Provider Demographics
NPI:1659133635
Name:REYES, JAY (RN, BSN, AMB-BC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:RN, BSN, AMB-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 102ND ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0307
Mailing Address - Country:US
Mailing Address - Phone:212-241-5656
Mailing Address - Fax:
Practice Address - Street 1:10 E 102ND ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-0307
Practice Address - Country:US
Practice Address - Phone:212-241-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685452163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care