Provider Demographics
NPI:1023151263
Name:REYES, FRANCISCO ALBERT ROJAS (PT)
Entity type:Individual
Prefix:
First Name:FRANCISCO ALBERT
Middle Name:ROJAS
Last Name:REYES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 COATES AVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-6037
Mailing Address - Country:US
Mailing Address - Phone:516-450-5308
Mailing Address - Fax:
Practice Address - Street 1:761 COATES AVE
Practice Address - Street 2:SUITE 40
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-6037
Practice Address - Country:US
Practice Address - Phone:516-450-5308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025085OtherLICENSE