Provider Demographics
NPI:1083636393
Name:REINER, STEVEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:REINER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 GAINES ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-6902
Mailing Address - Country:US
Mailing Address - Phone:360-385-6486
Mailing Address - Fax:360-379-4996
Practice Address - Street 1:204 GAINES ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6902
Practice Address - Country:US
Practice Address - Phone:360-385-6486
Practice Address - Fax:360-379-4996
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00183200213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF11578OtherHEALTH NET
NJ098994900OtherINDEPENDENCE BC
NJ1006148OtherHORIZON NJ HEALTH
NJJ40585OtherAMERIHEALTH ADMINISTRADOR
NJ0380903Medicaid
NJ694258OtherCIGNA
NJ0073540000OtherAMERIHEALTH
NJ480020688OtherRAIL ROAD MEDICARE
NJ23332OtherAMERIGROUP
NJJP039OtherOXFORD
NJ098994900OtherINDEPENDENCE BC
NJ480020688OtherRAIL ROAD MEDICARE
NJ0380903Medicaid