Healthcare Provider Details

I. General information

NPI: 1992629604
Provider Name (Legal Business Name): JOSEPH ANTHONY REITANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N INGALLS ST
ANN ARBOR MI
48109-2003
US

IV. Provider business mailing address

2101 ARBORVIEW BLVD
ANN ARBOR MI
48103-3513
US

V. Phone/Fax

Practice location:
  • Phone: 734-763-5985
  • Fax:
Mailing address:
  • Phone: 810-516-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704399203
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: