Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 159835 | NY |
NPI | 1063513018 |
---|---|
Provider Name | Wesley Beth Reiss |
First Address | N Massapequa, NY 11758-3046 |
Second Address | Huntington, NY 11743-2619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0082445 | GHI (01) | NY |
0727234 | AETNA (01) | NY |
266380883 | CIGNA (01) | NY |
49430 | VYTRA (01) | NY |
D91820 | (02) | NY |
N11973 | HEALTHNET (01) | NY |
NYM159835 | CARE MANAGEMENT GROUP NY (01) | NY |
P951291 | OXFORD (01) | NY |