Provider Demographics
NPI:1184827172
Name:REISENBICHLER, EMILY SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SUZANNE
Last Name:REISENBICHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CEDAR ST
Mailing Address - Street 2:PO BOX 208023
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 CEDAR ST
Practice Address - Street 2:PO BOX 208023
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520-8023
Practice Address - Country:US
Practice Address - Phone:832-771-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49720207ZP0102X
CT56980207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology