Provider Demographics
NPI:1437130119
Name:CARL REIMERS MD
Entity Type:Organization
Organization Name:CARL REIMERS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:REIMERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-359-5843
Mailing Address - Street 1:1262 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5102
Mailing Address - Country:US
Mailing Address - Phone:718-859-5843
Mailing Address - Fax:718-859-6250
Practice Address - Street 1:1262 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5102
Practice Address - Country:US
Practice Address - Phone:718-859-5843
Practice Address - Fax:718-859-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179659207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G03153Medicare UPIN