Provider Demographics
NPI:1053004739
Name:REYES-ROJAS, CORAL
Entity type:Individual
Prefix:
First Name:CORAL
Middle Name:
Last Name:REYES-ROJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 RICHBORO RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1534
Mailing Address - Country:US
Mailing Address - Phone:484-798-3489
Mailing Address - Fax:
Practice Address - Street 1:226 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2216
Practice Address - Country:US
Practice Address - Phone:215-968-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant