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General NPI Number Information
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NPI Number | 1275055949
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Entity Type | Individual
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Provider Name | GEORGE ALLAN REUTERSHAN LMT,CH,BS
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Gender | Male
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/13/2017
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Provider Practice Location Address
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Address Line | 19 LAUREL AVE # 116
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City | CORNWALL
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State | NY
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Zip | 12518-1403
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Country | US
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Telephone | 845-497-1652
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Fax | 845-237-7186
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Provider Business Mailing Address
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Address Line | 24 CORNWALL AVE
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City | CORNWALL ON HUDSON
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State | NY
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Zip | 12520-1219
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Country | US
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Telephone | 845-497-1652
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Fax | 845-237-7186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 008100
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License Number State | NY
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