Provider Demographics
NPI:1245293513
Name:REYES, ELEIA JOYCE SERRANO (MD)
Entity type:Individual
Prefix:MISS
First Name:ELEIA JOYCE
Middle Name:SERRANO
Last Name:REYES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9582 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9709
Mailing Address - Country:US
Mailing Address - Phone:513-346-5640
Mailing Address - Fax:513-346-5644
Practice Address - Street 1:9582 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-9709
Practice Address - Country:US
Practice Address - Phone:513-346-5640
Practice Address - Fax:513-346-5644
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35071040R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282993Medicaid
OH0282993Medicaid
OHH123380Medicare PIN
G42992Medicare UPIN