Healthcare Provider Details

I. General information

NPI: 1790396687
Provider Name (Legal Business Name): JULIE PAULINE REINER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 CHURCH HILL RD
NEWTOWN CT
06470-1637
US

IV. Provider business mailing address

PO BOX 417594
BOSTON MA
02241-7594
US

V. Phone/Fax

Practice location:
  • Phone: 475-282-0932
  • Fax: 475-209-8054
Mailing address:
  • Phone: 914-294-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12777
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: