Provider Demographics
NPI:1124037593
Name:REIFER, HOWARD JAY (DPM)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:JAY
Last Name:REIFER
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 1:2019 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2549
Mailing Address - Country:US
Mailing Address - Phone:718-434-0711
Mailing Address - Fax:
Practice Address - Street 1:2019 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2549
Practice Address - Country:US
Practice Address - Phone:718-434-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005673213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02084788Medicaid
NYPB9641Medicare PIN
NYU81732Medicare UPIN
NY4208750001Medicare NSC
NY02084788Medicaid
NY08276Medicare PIN