Provider Demographics
NPI:1689911851
Name:REINHARDT, ADAM (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 DR SAMUEL MCCREE WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-3409
Mailing Address - Country:US
Mailing Address - Phone:585-235-7848
Mailing Address - Fax:585-464-6194
Practice Address - Street 1:198 DR SAMUEL MCCREE WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-3409
Practice Address - Country:US
Practice Address - Phone:585-235-7848
Practice Address - Fax:585-464-6194
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022927-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist