Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 180315-1 | NY |
NPI | 1033110689 |
---|---|
Provider Name | Herbert Reich |
First Address | Schenectady, NY 12308-2425 |
Second Address | Schenectady, NY 12308-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 26/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01665163 | (05) | NY |
G22973 | (02) |