Provider Demographics
NPI:1508025941
Name:REINGOLD, ANDREW LEWIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LEWIS
Last Name:REINGOLD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 COLUMBUS AVE
Mailing Address - Street 2:#7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5147
Mailing Address - Country:US
Mailing Address - Phone:212-724-4669
Mailing Address - Fax:
Practice Address - Street 1:111 W 57TH ST
Practice Address - Street 2:SUITE 1012
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2211
Practice Address - Country:US
Practice Address - Phone:212-724-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist