Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 136910 | NY |
NPI | 1033101019 |
---|---|
Provider Name | Dr. Paul M Reiter |
First Address | Kingston, NY 12401-5852 |
Second Address | Kingston, NY 12401-5852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 30/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00707319 | (05) | NY |
B17862 | (02) | NY |