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General NPI Number Information
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NPI Number | 1922368786
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Entity Type | Organization
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Legal Business Name | NOAH REISS MD PC
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 360 WASHINGTON AVE
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City | KINGSTON
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State | NY
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Zip | 12401
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Country | US
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Telephone | 845-802-7029
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Fax | 845-802-7031
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Provider Business Mailing Address
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Address Line | 108 N BALLSTON AVE
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City | SCOTIA
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State | NY
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Zip | 12302
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Country | US
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Telephone | 518-393-8629
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Fax | 518-393-8606
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Authorized Official
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Title or Position | PRESIDENT
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Name | NOAH REISS
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Credential | MD
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Telephone | 518-393-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 182615
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License Number State | NY
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