Healthcare Provider Details
I. General information
NPI: 1467556795
Provider Name (Legal Business Name): JAMES N REICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2006
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 N 35TH AVE SUITE 620
HOLLYWOOD FL
33021-5424
US
IV. Provider business mailing address
1150 N 35TH AVE SUITE 620
HOLLYWOOD FL
33021-5424
US
V. Phone/Fax
- Phone: 954-989-9553
- Fax: 954-989-9607
- Phone: 954-989-9553
- Fax: 954-989-9607
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | 82676 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: