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NPI Code Detail

MEDICARE: MICHELLE REISNER, M.D., L.L.C.

MEDICARE: MICHELLE REISNER, M.D., L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianNJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14380001858OTHERNJRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010050929NJ01OTHERNJANTHEM
22032576001OTHERNJAMERIHEALTH
31075405OTHERNJHORIZON NJ HEALTH
41640475OTHERNJAETNA TRADITIONAL PLANS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6HUL000097-07OTHERNJAMERICHOICE
71022776OTHERNJHORIZON NJ HEALTH
8391536OTHERNJCIGNA
945671OTHERNJAETNA HMO
1023072OTHERNJAMERIGROUP
11264AH2OTHERNJWELLCHOICE
1215262OTHERNJPPONEXT
13264AH1OTHERNJWELLCHOICE
15809742OTHERNJUNITED HEALTHCARE
16HP231OTHERNJOXFORD
17HUL000097-08OTHERNJAMERICHOICE

General Provider Information

NPI Number : 1053366948
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHELLE REISNER, M.D., L.L.C.
Provider Business Mailing Address
First Line : PO BOX 729
Second Line :
City : TENAFLY
State : NJ
Zip : 07670-0729
Country : US
Telephone Number : 201-332-3354
Fax Number : 201-536-9047
Provider Business Practice Location Address
First Line : 196 JEWETT AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07304-1804
Country : US
Telephone Number : 201-332-3354
Fax Number : 201-536-9047
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHELE R REISNER
Credential : MD
Telephone Number : 201-332-3354
Provider Enumeration Date : 05/23/2006
Last Update Date : 07/21/2022

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