Provider Demographics
NPI:1295123248
Name:TAYLOR-REID, DEAN ELETHIA (DNP)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ELETHIA
Last Name:TAYLOR-REID
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 DEMOTT ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2330
Mailing Address - Country:US
Mailing Address - Phone:201-233-0554
Mailing Address - Fax:
Practice Address - Street 1:65 DEMOTT ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2330
Practice Address - Country:US
Practice Address - Phone:201-541-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00522500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health