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:
Health care specialties
Specialty | Code | License # | 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 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1336690494 | NPPES |
New York | Other | 215600411 | STATE ID |
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