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General NPI Number Information
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NPI Number | 1861153272
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Entity Type | Individual
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Provider Name | SUSAN REISMAN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 901 WALNUT ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5224
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Country | US
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Telephone | 215-955-7000
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Fax | 215-503-9357
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Provider Business Mailing Address
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Address Line | 901 WALNUT ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5224
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Country | US
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Telephone | 215-955-7000
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Fax | 215-503-9357
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 310518
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License Number State | NY
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