Provider Demographics
NPI:1073679833
Name:REINSTEIN, PATRICIA COWAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:COWAN
Last Name:REINSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3524
Mailing Address - Country:US
Mailing Address - Phone:781-862-0747
Mailing Address - Fax:781-862-0636
Practice Address - Street 1:17 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3524
Practice Address - Country:US
Practice Address - Phone:781-862-0747
Practice Address - Fax:781-862-0636
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2972103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALICENSE #2972OtherMA LICENSED PSYCHOLOGIST
MAWO3610OtherBLUECROSSBLUESHIELD OF MA