Provider Demographics
NPI:1609897685
Name:REINSEL, KRISTEN MARIA (MPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIA
Last Name:REINSEL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 BRILLIANT AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3124
Mailing Address - Country:US
Mailing Address - Phone:412-999-5499
Mailing Address - Fax:
Practice Address - Street 1:304 BRILLIANT AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3124
Practice Address - Country:US
Practice Address - Phone:412-999-5499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017153225100000X
PADAPT001497225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019247060001OtherMEDICAL ASSISTANCE
PA199340OtherUNISON
FLY906HOtherBLUE CROSS/BLUE SHIELD
PAKU1965163OtherHIGHMARK
PA1551432OtherGATEWAY
PAKU1965163OtherHIGHMARK
PA1551432OtherGATEWAY