Provider Demographics
NPI:1902196314
Name:REIS PEDIATRICS LLC
Entity Type:Organization
Organization Name:REIS PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIJIIT
Authorized Official - Middle Name:
Authorized Official - Last Name:REIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-263-8822
Mailing Address - Street 1:30 AULIKE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2739
Mailing Address - Country:US
Mailing Address - Phone:808-263-8822
Mailing Address - Fax:808-261-6749
Practice Address - Street 1:30 AULIKE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2739
Practice Address - Country:US
Practice Address - Phone:808-263-8822
Practice Address - Fax:808-261-6749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI526400Medicaid
HI50832701Medicaid
HI50832701Medicaid