Healthcare Provider Details

I. General information

NPI: 1861759565
Provider Name (Legal Business Name): FRIEDERIKE REINSBERGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4B CRAGMORE RD
NEWTON MA
02464-1009
US

IV. Provider business mailing address

4B CRAGMORE RD
NEWTON MA
02464-1009
US

V. Phone/Fax

Practice location:
  • Phone: 617-817-5561
  • Fax:
Mailing address:
  • Phone: 617-817-5561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number250176
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: