Provider Demographics
NPI:1740348531
Name:REIERSEN, ERIK J (MD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:J
Last Name:REIERSEN
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 1:217 COOK ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3503
Mailing Address - Country:US
Mailing Address - Phone:516-729-4108
Mailing Address - Fax:631-849-1052
Practice Address - Street 1:471 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4414
Practice Address - Country:US
Practice Address - Phone:631-849-1050
Practice Address - Fax:631-849-1052
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213746-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01962298Medicaid
NYER03209N10OtherBLUE CROSS BLUE SHIELD
NY213746-1 1WOtherWORKERS COMPENSATION
NYER030B6610Medicare ID - Type Unspecified
NY213746-1 1WOtherWORKERS COMPENSATION