Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 277420 | NY |
N | 207PE0004X | Emergency Medical Services | 277420 | NY |
NPI | 1184923047 |
---|---|
Provider Name | Dr. Nathan Reisman |
First Address | Brooklyn, NY 11203-2012 |
Second Address | Brooklyn, NY 11203-2012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2011 |
Last Update Date | 28/02/2015 |