Provider Demographics
NPI:1912194069
Name:REIBER, STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:REIBER
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 1:4 TOBEY LN
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1226
Mailing Address - Country:US
Mailing Address - Phone:845-354-1181
Mailing Address - Fax:845-354-1377
Practice Address - Street 1:12A N AIRMONT RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5152
Practice Address - Country:US
Practice Address - Phone:845-354-1181
Practice Address - Fax:845-354-1377
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174829207R00000X
NJ51907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY37M961Medicare PIN
110115312Medicare PIN
F97924Medicare UPIN
NJ077696Medicare PIN