Provider Demographics
NPI:1013097286
Name:COWART, REESHEMAN GENEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:REESHEMAN
Middle Name:GENEE
Last Name:COWART
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 KINGSBRIDGE TER
Mailing Address - Street 2:#3H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7503
Mailing Address - Country:US
Mailing Address - Phone:718-329-3509
Mailing Address - Fax:
Practice Address - Street 1:2630 KINGSBRIDGE TER
Practice Address - Street 2:#3H
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7503
Practice Address - Country:US
Practice Address - Phone:718-329-3509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006169213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPL297P1321Medicare PIN