Provider Demographics
NPI:1760760458
Name:REIFEL, LUCY MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:MARIA
Last Name:REIFEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:ROSEBUD
Mailing Address - State:SD
Mailing Address - Zip Code:57570-0719
Mailing Address - Country:US
Mailing Address - Phone:605-747-5100
Mailing Address - Fax:
Practice Address - Street 1:100 DIALYSIS LANE
Practice Address - Street 2:
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570
Practice Address - Country:US
Practice Address - Phone:605-747-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2508208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics