De Jesus, Mark Reyes

De Jesus, Mark Reyes is an sole proprietor health care provider with primary practice located at 8611 Whitney Ave 3M, Elmhurst NY 11373-3668. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. De Jesus, Mark Reyes can be contacted via phone (646) 651-3530.

Contact Information

Primary practice address
8611 Whitney Ave 3M Elmhurst NY 11373-3668
Phone: (646) 651-3530
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1336690494
LBN Legal business name De Jesus, Mark Reyes
Credentials MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2016
Last updated Oct 24th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336690494 NPPES
New York Other 215600411 STATE ID

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