MEDICARE: SHOSHANA LEAH REINHART

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	363A00000X	Physician Assistant	25MP01012000	NJ

General Provider Information

NPI Number	:	1457044687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHOSHANA LEAH REINHART

Provider Business Mailing Address
First Line	:	3 UNIVERSITY PLZ STE 205
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-6208
Country	:	US
Telephone Number	:	201-833-3599
Fax Number	:	201-227-6207

Provider Business Practice Location Address
First Line	:	730 PALISADE AVE
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-3144
Country	:	US
Telephone Number	:	201-353-9000
Fax Number	:	201-530-0003

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

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	05/12/2026

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Directions to “ SHOSHANA LEAH REINHART ” Practice Location

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