Basic Information
Provider Information
NPI: 1134642598
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REEVES
FirstName: LUVA
MiddleName: M
NamePrefix: MS.
NameSuffix:  
Credential: MSN, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 55 WATER STREET
Address2: 2ND FLOOR CRED DEPT
City: NEW YORK
State: NY
PostalCode: 100410004
CountryCode: US
TelephoneNumber: 6466802888
FaxNumber: 5165425556
Practice Location
Address1: 3245 NOSTRAND AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 11229
CountryCode: US
TelephoneNumber: 7186153777
FaxNumber: 7186153717
Other Information
ProviderEnumerationDate: 07/18/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XF341003-1NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home