Provider Demographics
NPI:1043498645
Name:STEVEN REINER, DPM
Entity Type:Organization
Organization Name:STEVEN REINER, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-779-8080
Mailing Address - Street 1:2 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-2620
Mailing Address - Country:US
Mailing Address - Phone:856-779-8080
Mailing Address - Fax:856-482-7286
Practice Address - Street 1:2 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MAPLE SHADE
Practice Address - State:NJ
Practice Address - Zip Code:08052-2620
Practice Address - Country:US
Practice Address - Phone:856-779-8080
Practice Address - Fax:856-482-7286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD001832332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0829720001Medicare NSC
0829720001Medicare NSC