Provider Demographics
NPI:1992023725
Name:LOUIS REICHERT PA
Entity Type:Organization
Organization Name:LOUIS REICHERT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:REICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:561-477-3083
Mailing Address - Street 1:PO BOX 880627
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33488-0627
Mailing Address - Country:US
Mailing Address - Phone:561-477-3083
Mailing Address - Fax:561-883-7169
Practice Address - Street 1:9045 LA FONTANA BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5636
Practice Address - Country:US
Practice Address - Phone:561-477-3083
Practice Address - Fax:561-883-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74330Medicare PIN