Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 300407 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 300407 | NY |
NPI | 1144456880 |
---|---|
Provider Name | Henry Edward Dela Cruz Reyes |
First Address | Buffalo, NY 14240-0488 |
Second Address | Williamsville, NY 14221-7889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 08/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03404666 | (05) | NY |