Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 231912 | NY |
NPI | 1295763670 |
---|---|
Provider Name | Dr. Tara Lyn Reimer |
First Address | Orchard Park, NY 14127-2604 |
Second Address | Orchard Park, NY 14127-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 10/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00026878601 | UNIVERA HEALTHCARE (01) | NY |
000527699001 | BLUE CROSS/BLUE SHIELD (HEALTH NOW) (01) | NY |
02563968 | (05) | NY |
1212532 | INDEPENDENT HEALTH ASSOCIATION (01) | NY |