Provider Demographics
NPI:1710089263
Name:REIFE, MICHAEL D (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:REIFE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:8 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-1408
Mailing Address - Country:US
Mailing Address - Phone:860-295-1200
Mailing Address - Fax:860-295-1201
Practice Address - Street 1:8 INDEPENDENCE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447-1408
Practice Address - Country:US
Practice Address - Phone:860-295-1200
Practice Address - Fax:860-295-1201
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000719111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP415571OtherOXFORD
CT766400OtherCONNECTICARE
CT050000719CT01OtherBLUE CROSS/BLUE SHIELD
CT766400OtherCONNECTICARE