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General NPI Number Information
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NPI Number | 1295703346
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Entity Type | Organization
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Legal Business Name | SUSAN REISINGER, MD PROF. CORP.
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 2851 N TENAYA WAY STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89128-0453
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Country | US
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Telephone | 702-243-3340
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Fax | 702-228-4724
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Provider Business Mailing Address
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Address Line | PO BOX 745059
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City | LOS ANGELES
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State | CA
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Zip | 90074-5059
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Country | US
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Telephone | 702-508-9944
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Fax | 702-508-9944
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MELISSA SCHROADER
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Credential | CREDENTIALING
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Telephone | 602-932-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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