Provider Demographics
NPI:1245395151
Name:REITMAN, MARC WEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:WEIL
Last Name:REITMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:755 NEW YORK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4240
Mailing Address - Country:US
Mailing Address - Phone:631-427-1597
Mailing Address - Fax:631-424-4041
Practice Address - Street 1:755 NEW YORK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4240
Practice Address - Country:US
Practice Address - Phone:631-427-1597
Practice Address - Fax:631-424-4041
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1365002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF67938Medicare UPIN