Healthcare Provider Details

I. General information

NPI: 1639161037
Provider Name (Legal Business Name): CARL DIETRICH REIMERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CLOCK TOWER CMNS
BREWSTER NY
10509-4055
US

IV. Provider business mailing address

111 CLOCK TOWER CMNS
BREWSTER NY
10509-4055
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5187
  • Fax: 855-703-7570
Mailing address:
  • Phone: 845-279-5187
  • Fax: 855-703-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number179659
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number179659
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: