Provider Demographics
NPI:1255457800
Name:DAVID R REICH MD
Entity type:Organization
Organization Name:DAVID R REICH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOMBROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-252-6836
Mailing Address - Street 1:37 W GARDEN ST
Mailing Address - Street 2:STE 108
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2662
Mailing Address - Country:US
Mailing Address - Phone:315-252-6836
Mailing Address - Fax:315-253-0082
Practice Address - Street 1:37 W GARDEN ST
Practice Address - Street 2:STE 108
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-2662
Practice Address - Country:US
Practice Address - Phone:315-252-6836
Practice Address - Fax:315-253-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155964-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00793206Medicaid
NYB82379Medicare UPIN
NY39243BMedicare ID - Type Unspecified