Provider Demographics
NPI:1689419996
Name:REID, MICHELE ANGELA
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANGELA
Last Name:REID
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 1:2023 CICERO AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-1849
Mailing Address - Country:US
Mailing Address - Phone:917-531-4245
Mailing Address - Fax:
Practice Address - Street 1:2023 CICERO AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1849
Practice Address - Country:US
Practice Address - Phone:917-531-4245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator