Provider Demographics
NPI:1649085069
Name:REICHEY, DECLAN ROBERT
Entity type:Individual
Prefix:
First Name:DECLAN
Middle Name:ROBERT
Last Name:REICHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3831
Mailing Address - Country:US
Mailing Address - Phone:732-233-8512
Mailing Address - Fax:
Practice Address - Street 1:40 CHRISTOPHER WAY
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3346
Practice Address - Country:US
Practice Address - Phone:888-597-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst