Provider Demographics
NPI:1114453867
Name:REINHOLD, ELIEZER
Entity Type:Individual
Prefix:MR
First Name:ELIEZER
Middle Name:
Last Name:REINHOLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 PARKVILLE AVE APT B1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1111
Mailing Address - Country:US
Mailing Address - Phone:917-995-2822
Mailing Address - Fax:
Practice Address - Street 1:131 PARKVILLE AVE APT B1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1111
Practice Address - Country:US
Practice Address - Phone:917-995-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP05683103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst