Provider Demographics
NPI:1851482822
Name:REINHARDT, CAROL IRENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:IRENE
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 PENBROOKE DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2044
Mailing Address - Country:US
Mailing Address - Phone:585-678-4773
Mailing Address - Fax:585-678-4387
Practice Address - Street 1:481 PENBROOKE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2044
Practice Address - Country:US
Practice Address - Phone:585-678-4773
Practice Address - Fax:585-678-4387
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009419103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100294FCOtherPREFERRED CARE PIN#
NY009419OtherUNITED BEHAVIORAL HEALTH
NY009419OtherCIGNA
NY6891437OtherEMPIRE PLAN, VALUE OPTION
NYPO20009419OtherBLUE SHIELD PIN#
NY4588509OtherAETNA PIN#
NM009419OtherUNITED HEALTHCARE
NYPO10009419OtherBLUE CHOICE PIN#
NYPO10009419OtherMONROE PLAN PIN#
NY100294FCOtherPREFERRED CARE PIN#