Provider Demographics
NPI:1346366309
Name:REINHARDT, MICHAEL WALTER (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WALTER
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-3007
Mailing Address - Country:US
Mailing Address - Phone:585-872-1090
Mailing Address - Fax:585-872-1098
Practice Address - Street 1:27 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-3007
Practice Address - Country:US
Practice Address - Phone:585-872-1090
Practice Address - Fax:585-872-1098
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-009570111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY106007ANOtherPREFERRED CARE
NYP010009570OtherBLUE CHOICE
NYP020009570OtherBLUE CROSS BLUE SHIELD RA
NYP010009570OtherBLUE CHOICE