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General NPI Number Information
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NPI Number | 1508025941
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Entity Type | Individual
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Provider Name | ANDREW LEWIS REINGOLD D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 111 W 57TH ST SUITE 1012
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City | NEW YORK
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State | NY
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Zip | 10019-2211
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Country | US
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Telephone | 212-724-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 463 COLUMBUS AVE #7
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City | NEW YORK
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State | NY
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Zip | 10024-5147
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Country | US
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Telephone | 212-724-4669
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 048445
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License Number State | NY
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