Provider Demographics
NPI:1457587594
Name:REINHARDT, MICHAEL MARION JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MARION
Last Name:REINHARDT
Suffix:JR
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 1:450 CLARKSON AVE
Mailing Address - Street 2:SUNY DOWNSTATE MEDICAL CENTER BOX 1203
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:718-270-2003
Mailing Address - Fax:718-270-2619
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:SUNY DOWNSTATE MEDICAL CENTER BOX 1203
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-2003
Practice Address - Fax:718-270-2619
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2659022084P0800X
NY2659202084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry