Provider Demographics
NPI:1427218411
Name:RONALD A REISS MD
Entity Type:Organization
Organization Name:RONALD A REISS MD
Other - Org Name:RONALD A REISS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:REISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-359-1345
Mailing Address - Street 1:312 US HIGHWAY 206
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4692
Mailing Address - Country:US
Mailing Address - Phone:908-359-1345
Mailing Address - Fax:
Practice Address - Street 1:312 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4692
Practice Address - Country:US
Practice Address - Phone:908-359-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO3805200261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56368Medicare UPIN