Basic Information
| Provider Information | |||||||||
| NPI: | 1275258832 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REYES | ||||||||
| FirstName: | KATERINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 845 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106032427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147610600 | ||||||||
| FaxNumber: | 9147615367 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PEEKSKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105662907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2022 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 293161 | NY | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.