Provider Demographics
NPI:1326144866
Name:REIZER, LORI JAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:JAYNE
Last Name:REIZER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 RAMTOWN GREENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3830
Mailing Address - Country:US
Mailing Address - Phone:732-458-1216
Mailing Address - Fax:732-458-8953
Practice Address - Street 1:66 RAMTOWN GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3830
Practice Address - Country:US
Practice Address - Phone:732-458-1216
Practice Address - Fax:732-458-8953
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00333100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT93200Medicare UPIN
NJ603975CYKMedicare ID - Type Unspecified