Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 2000-01425 | NC |
N | 207KA0200X | Allergist | 53068 | GA |
NPI | 1538311311 |
---|---|
Provider Name | Dr. Colin Reisner |
First Address | Morristown, NJ 07960 |
Second Address | Morristown, NJ 07869-1828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2008 |
Last Update Date | 04/02/2013 |