MEDICARE: DR. KEITH ROBERT REINHARDT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	TBD	NY

General Provider Information

NPI Number	:	1427224591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH ROBERT REINHARDT M.D.

Provider Business Mailing Address
First Line	:	31 JETMORE PL
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-7813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 E MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8407
Country	:	US
Telephone Number	:	631-968-3777
Fax Number	:	631-675-4206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	06/11/2013

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