Provider Demographics
NPI:1235129669
Name:REICH, STUART H (PA)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:H
Last Name:REICH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:115 FRANKLIN TPKE STE 238
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1325
Mailing Address - Country:US
Mailing Address - Phone:845-357-2548
Mailing Address - Fax:888-972-3703
Practice Address - Street 1:115 FRANKLIN TPKE STE 238
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1325
Practice Address - Country:US
Practice Address - Phone:845-357-2548
Practice Address - Fax:845-261-0436
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001965363A00000X, 363AS0400X
FLPA3075363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS48624Medicare UPIN