Provider Demographics
NPI:1689460511
Name:REITZ, ALEXANDER W (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:W
Last Name:REITZ
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1460
Mailing Address - Country:US
Mailing Address - Phone:615-414-6915
Mailing Address - Fax:
Practice Address - Street 1:239 FISHER RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1460
Practice Address - Country:US
Practice Address - Phone:615-414-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2389655163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health