Healthcare Provider Details

I. General information

NPI: 1700119476
Provider Name (Legal Business Name): ROBERT S. REIFFEL, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 GREENRIDGE AVE SUITE 203
WHITE PLAINS NY
10605-1238
US

IV. Provider business mailing address

12 GREENRIDGE AVE SUITE 203
WHITE PLAINS NY
10605-1238
US

V. Phone/Fax

Practice location:
  • Phone: 914-683-1400
  • Fax: 914-683-0144
Mailing address:
  • Phone: 914-683-1400
  • Fax: 914-683-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number116755
License Number StateNY

VIII. Authorized Official

Name: DR. ROBERT S REIFFEL
Title or Position: PHYSICIAN/PRESIDENT
Credential: MD
Phone: 914-683-1400