Provider Demographics
NPI:1881564847
Name:REYES-FLORES, SUGELY
Entity type:Individual
Prefix:
First Name:SUGELY
Middle Name:
Last Name:REYES-FLORES
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 1:543 W 211TH ST APT 41B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5955
Mailing Address - Country:US
Mailing Address - Phone:646-207-2595
Mailing Address - Fax:
Practice Address - Street 1:543 W 211TH ST APT 41B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5955
Practice Address - Country:US
Practice Address - Phone:646-207-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033315124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist