=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326353202
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOEL M REIN, MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2010
-----------------------------------------------------
Last Update Date | 08/16/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 1/2 DEARFIELD DR
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06831-5335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-869-9850
-----------------------------------------------------
Fax | 203-869-5915
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 1/2 DEARFIELD DR
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06831-5335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-869-9850
-----------------------------------------------------
Fax | 203-869-5915
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JOEL M REIN
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 203-869-9850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | 015473
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------