Provider Demographics
NPI:1306190863
Name:BONNIE S REICHMAN, MD, FACP, LLC
Entity Type:Organization
Organization Name:BONNIE S REICHMAN, MD, FACP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:REICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-688-7715
Mailing Address - Street 1:30 E 60TH ST
Mailing Address - Street 2:SUITE 701
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1008
Mailing Address - Country:US
Mailing Address - Phone:212-688-7715
Mailing Address - Fax:212-688-7726
Practice Address - Street 1:30 E 60TH ST
Practice Address - Street 2:SUITE 701
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1008
Practice Address - Country:US
Practice Address - Phone:212-688-7715
Practice Address - Fax:212-688-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty