Provider Demographics
NPI:1154752061
Name:REYES, NATALIA ENID (LPN)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:ENID
Last Name:REYES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SUNNYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-1137
Mailing Address - Country:US
Mailing Address - Phone:585-355-3151
Mailing Address - Fax:
Practice Address - Street 1:51 SUNNYSIDE LN
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-1137
Practice Address - Country:US
Practice Address - Phone:585-355-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292402164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse