Healthcare Provider Details

I. General information

NPI: 1306183884
Provider Name (Legal Business Name): JAMES S. REIBEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 DOUBLING ROAD
GREENWICH CT
06830
US

IV. Provider business mailing address

42 DOUBLING ROAD
GREENWICH CT
06830
US

V. Phone/Fax

Practice location:
  • Phone: 203-661-0294
  • Fax: 203-629-9441
Mailing address:
  • Phone: 203-661-0294
  • Fax: 203-629-9441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number022104
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: