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General NPI Number Information
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NPI Number | 1720278146
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Entity Type | Organization
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Legal Business Name | MARJORIE A. REID, M.D., P.C.
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 560 NORTHERN BLVD SUITE 202B
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City | GREAT NECK
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State | NY
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Zip | 11021-5100
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Country | US
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Telephone | 516-365-6547
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Fax |
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Provider Business Mailing Address
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Address Line | 560 NORTHERN BLVD SUITE 202B
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City | GREAT NECK
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State | NY
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Zip | 11021-5100
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Country | US
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Telephone | 516-365-6547
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARJORIE A. REID
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Credential | M.D.
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Telephone | 516-365-6547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 224105
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License Number State | NY
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