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General NPI Number Information
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NPI Number | 1427218411
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Entity Type | Organization
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Legal Business Name | RONALD A REISS MD
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Dates
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Enumeration Date | 06/12/2008
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 312 US HIGHWAY 206
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-4692
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Country | US
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Telephone | 908-359-1345
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Fax |
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Provider Business Mailing Address
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Address Line | 312 US HIGHWAY 206
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-4692
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Country | US
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Telephone | 908-359-1345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD ALFRED REISS
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Credential | M.D.
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Telephone | 908-359-1345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MAO3805200
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License Number State | NJ
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