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NPI Code Detail

MEDICARE: MS. GERI REINHARDT LICSW (MSW)

MEDICARE: MS. GERI REINHARDT LICSW (MSW)
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
11041C0700XClinical Social Worker104151MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PO3262OTHERMABCBSMA

General Provider Information

NPI Number : 1841402666
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GERI REINHARDT LICSW (MSW)
Provider Business Mailing Address
First Line : 650 COMMONWEALTH AVENUE
Second Line :
City : NEWTON
State : MA
Zip : 02459-1536
Country : US
Telephone Number : 617-964-1799
Fax Number : 617-969-0575
Provider Business Practice Location Address
First Line : 650 COMMONWEALTH AVENUE
Second Line :
City : NEWTON
State : MA
Zip : 02459-1536
Country : US
Telephone Number : 617-964-1799
Fax Number : 617-969-0575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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