Provider Demographics
NPI:1821428004
Name:JENNIFER REYNA
Entity Type:Organization
Organization Name:JENNIFER REYNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-602-1200
Mailing Address - Street 1:955 E 163RD ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-4290
Mailing Address - Country:US
Mailing Address - Phone:347-602-1200
Mailing Address - Fax:
Practice Address - Street 1:955 E 163RD ST APT 4C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-4290
Practice Address - Country:US
Practice Address - Phone:347-602-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency