MEDICARE: DR. EDWARD J REICH M.D.

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
1	174400000X	Specialist	098992	NY

General Provider Information

NPI Number	:	1457388001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD J REICH M.D.

Provider Business Mailing Address
First Line	:	55 E 72ND ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4149
Country	:	US
Telephone Number	:	212-794-2777
Fax Number	:	212-439-0672

Provider Business Practice Location Address
First Line	:	55 E 72ND ST
Second Line	:	1E
City	:	NEW YORK
State	:	NY
Zip	:	10021-4149
Country	:	US
Telephone Number	:	212-794-2777
Fax Number	:	212-439-0672

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	07/10/2007

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