Provider Demographics
NPI:1619703279
Name:DELOS REYES, JOSEP C (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JOSEP
Middle Name:C
Last Name:DELOS REYES
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 HOFFMAN DR APT 2
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4978
Mailing Address - Country:US
Mailing Address - Phone:646-421-3929
Mailing Address - Fax:
Practice Address - Street 1:5730 HOFFMAN DR APT 2
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4978
Practice Address - Country:US
Practice Address - Phone:646-421-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY956646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse