Provider Demographics
NPI:1891105268
Name:REYNOLDS, CALI M (MD)
Entity Type:Individual
Prefix:
First Name:CALI
Middle Name:M
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 TADMUCK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3136
Mailing Address - Country:US
Mailing Address - Phone:978-619-5447
Mailing Address - Fax:879-692-8800
Practice Address - Street 1:68 TADMUCK RD STE 3
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3136
Practice Address - Country:US
Practice Address - Phone:978-619-5447
Practice Address - Fax:879-692-8800
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY298312207K00000X
MA283522207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program