Provider Demographics
NPI:1568480564
Name:RHEINSTEIN, JOHN (CP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:RHEINSTEIN
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3530
Mailing Address - Country:US
Mailing Address - Phone:917-589-1015
Mailing Address - Fax:212-222-0422
Practice Address - Street 1:905 W END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3530
Practice Address - Country:US
Practice Address - Phone:917-589-1015
Practice Address - Fax:212-222-0422
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD40187290001Medicaid
NY01720025Medicaid