Healthcare Provider Details

I. General information

NPI: 1114048055
Provider Name (Legal Business Name): BEATRIU REIG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 1ST AVE
NEW YORK NY
10016
US

IV. Provider business mailing address

560 1ST AVE
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5230
  • Fax: 646-754-9560
Mailing address:
  • Phone: 917-626-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number238055
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: