Healthcare Provider Details

I. General information

NPI: 1891386306
Provider Name (Legal Business Name): JAMES GORDON REITER DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 INNOVATION DR
YORK PA
17408-8815
US

IV. Provider business mailing address

1000 STEVENSON LN
TOWSON MD
21286-7918
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-8623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR207197
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number133609
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN744240
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: