Healthcare Provider Details

I. General information

NPI: 1316262827
Provider Name (Legal Business Name): MRS. DANIELLE MARIE GELINAS REITER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 PARK PL
LONG BEACH NY
11561-2111
US

IV. Provider business mailing address

7430 260TH ST
GLEN OAKS NY
11004-1123
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-0800
  • Fax:
Mailing address:
  • Phone: 718-343-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048264
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: