Provider Demographics
NPI:1184783243
Name:REYES, ELSA JACQUELINE (MD)
Entity type:Individual
Prefix:MS
First Name:ELSA
Middle Name:JACQUELINE
Last Name:REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:75 E 116TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1150
Mailing Address - Country:US
Mailing Address - Phone:212-828-7000
Mailing Address - Fax:212-828-7700
Practice Address - Street 1:75 E 116TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-1150
Practice Address - Country:US
Practice Address - Phone:212-828-7000
Practice Address - Fax:212-828-7800
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine