Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 30462 | MA |
NPI | 1003842543 |
---|---|
Provider Name | Dr. Marshall Lawrence Reiner,Jr |
First Address | Brookline, MA 02446-3885 |
Second Address | Brookline, MA 02446-3885 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B76747 | (02) |