Provider Demographics
NPI:1225208143
Name:RAINA, REETA (OD)
Entity Type:Individual
Prefix:DR
First Name:REETA
Middle Name:
Last Name:RAINA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27838 NOVI RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3019
Mailing Address - Country:US
Mailing Address - Phone:248-348-2900
Mailing Address - Fax:248-344-0908
Practice Address - Street 1:27838 NOVI RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3019
Practice Address - Country:US
Practice Address - Phone:248-348-2900
Practice Address - Fax:248-344-0908
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003911152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN26930211,N34040112Medicare PIN