Healthcare Provider Details

I. General information

NPI: 1093917841
Provider Name (Legal Business Name): REENA SINI JOSEPH M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REENA ALEYAMMA JOHN M.D.

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

IV. Provider business mailing address

2701 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

V. Phone/Fax

Practice location:
  • Phone: 919-739-8680
  • Fax: 919-739-8616
Mailing address:
  • Phone: 919-739-8680
  • Fax: 919-739-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2008-01990
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: