Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 203024 | NY |
NPI | 1023093721 |
---|---|
Provider Name | Dr. Jonathan Max Rieber |
First Address | Scarsdale, NY 10583 |
Second Address | New York, NY 10034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 06/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02250420 | (05) | NY |