Provider Demographics
NPI:1558686725
Name:REINSTEIN, DANIEL KENDIG IV (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KENDIG
Last Name:REINSTEIN
Suffix:IV
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-8030
Mailing Address - Country:US
Mailing Address - Phone:781-861-7081
Mailing Address - Fax:781-861-3625
Practice Address - Street 1:187 SPRING ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-8030
Practice Address - Country:US
Practice Address - Phone:781-861-7081
Practice Address - Fax:781-861-3625
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4242103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist