Healthcare Provider Details

I. General information

NPI: 1801875323
Provider Name (Legal Business Name): ELLEN S REINHEIMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

IV. Provider business mailing address

210 WESTCHESTER AVE 3RD FLOOR
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-3100
  • Fax: 914-682-6403
Mailing address:
  • Phone: 914-681-3146
  • Fax: 914-682-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number219830
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number039271
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: