Provider Demographics
NPI:1841426483
Name:REISH, ANDREW G (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:G
Last Name:REISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3308
Mailing Address - Country:US
Mailing Address - Phone:610-776-8344
Mailing Address - Fax:610-776-3168
Practice Address - Street 1:850 S 5TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3308
Practice Address - Country:US
Practice Address - Phone:610-776-8344
Practice Address - Fax:610-776-3168
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451917208100000X
MI4301102158208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation