Provider Demographics
NPI:1639156334
Name:REIHER, HERBERT WALTER (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:WALTER
Last Name:REIHER
Suffix:
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 1:30 JORDAN LN
Mailing Address - Street 2:PRIME HEALTHCARE
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1278
Mailing Address - Country:US
Mailing Address - Phone:860-263-0253
Mailing Address - Fax:860-263-0262
Practice Address - Street 1:1340 SULLIVAN AVE
Practice Address - Street 2:PRIME HEALTHCARE
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2713
Practice Address - Country:US
Practice Address - Phone:860-644-1521
Practice Address - Fax:860-644-3335
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028631207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT028631OtherMEDICAL LICENSE
CT010028631CT01OtherBCBS
CT001286310Medicaid
CT001286310Medicaid
CT028631OtherMEDICAL LICENSE
E58372Medicare UPIN