Provider Demographics
NPI:1154514081
Name:PAREDES, REYNA MERCEDES
Entity type:Individual
Prefix:
First Name:REYNA
Middle Name:MERCEDES
Last Name:PAREDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10870 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-2081
Mailing Address - Country:US
Mailing Address - Phone:917-459-7408
Mailing Address - Fax:
Practice Address - Street 1:2021 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4304
Practice Address - Country:US
Practice Address - Phone:718-960-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator