Provider Demographics
NPI:1275055949
Name:REUTERSHAN, GEORGE ALLAN (LMT,CH,BS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALLAN
Last Name:REUTERSHAN
Suffix:
Gender:M
Credentials:LMT,CH,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CORNWALL AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12520-1219
Mailing Address - Country:US
Mailing Address - Phone:845-497-1652
Mailing Address - Fax:845-237-7186
Practice Address - Street 1:19 LAUREL AVE # 116
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1403
Practice Address - Country:US
Practice Address - Phone:845-497-1652
Practice Address - Fax:845-237-7186
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist