MEDICARE: JOHN REISER

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	363LF0000X	Family Nurse Practitioner	SP009045	PA

General Provider Information

NPI Number	:	1821047598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN REISER

Provider Business Mailing Address
First Line	:	1 SAINT FRANCIS WAY
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 SAINT FRANCIS WAY
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5119
Country	:	US
Telephone Number	:	412-432-7400
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/28/2021

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