Provider Demographics
NPI:1548412232
Name:FREDERICK REICHLE MEDICAL PC
Entity Type:Organization
Organization Name:FREDERICK REICHLE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:ADOLPH
Authorized Official - Last Name:REICHLE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:267-971-6930
Mailing Address - Street 1:2169 CRESTWALD TERRACE
Mailing Address - Street 2:SUITE 67
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976
Mailing Address - Country:US
Mailing Address - Phone:267-971-6930
Mailing Address - Fax:215-491-3178
Practice Address - Street 1:40 S 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1016
Practice Address - Country:US
Practice Address - Phone:267-971-6930
Practice Address - Fax:215-491-3178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006646E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty