Provider Demographics
NPI:1255402913
Name:PAMELA A REINHARDT, MD
Entity type:Organization
Organization Name:PAMELA A REINHARDT, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-562-0519
Mailing Address - Street 1:96 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2733
Mailing Address - Country:US
Mailing Address - Phone:518-562-0519
Mailing Address - Fax:518-562-3316
Practice Address - Street 1:96 COURT ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2733
Practice Address - Country:US
Practice Address - Phone:518-562-0519
Practice Address - Fax:518-562-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178439-6207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE16907Medicare UPIN
NYRB2778Medicare PIN
NYBA1055Medicare PIN
NY51752BMedicare PIN