Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 0101234891 | VA |
Y | 207KA0200X | Allergist | 12899 | NV |
NPI | 1235254640 |
---|---|
Provider Name | Dr. Maria R Reyes |
First Address | Reno, NV 89521-5941 |
Second Address | Reno, NV 89521-5941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 19/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010209935 | (05) | VA |
H44353 | (02) |