Provider Demographics
NPI:1477518751
Name:REISS, ARTHUR III
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:REISS
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ANCHORAGE LN
Mailing Address - Street 2:APT 5B
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2724
Mailing Address - Country:US
Mailing Address - Phone:516-526-6027
Mailing Address - Fax:
Practice Address - Street 1:6 ANCHORAGE LN
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2724
Practice Address - Country:US
Practice Address - Phone:516-802-3284
Practice Address - Fax:516-802-3284
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN9581Medicare ID - Type UnspecifiedPHYSICAL THERAPIST