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NPI Code Detail

MEDICARE: DR. LISA A. REICHERT M.D.

MEDICARE: DR. LISA A. REICHERT 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
1208000000XPediatrics Physician207613NY

General Provider Information

NPI Number : 1548301385
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA A. REICHERT M.D.
Provider Business Mailing Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-213-4400
Provider Business Practice Location Address
First Line : 2890 NIAGARA FALLS BLVD
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-1114
Country : US
Telephone Number : 716-807-7337
Fax Number : 716-213-4400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 01/29/2020

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